FALLS CHURCH, Va. –
The Defense Health Agency (DHA) introduced the five-year extension of the Laboratory Developed Tests (LDTs) Demonstration. The DHA prolonged the demonstration from July 19, 2023 by way of July 18, 2028. This implies that when you have TRICARE, you’ll proceed to have entry to sure LDTs that aren’t accredited by the Food and Drug Administration.
The DHA additionally introduced that TRICARE will now cowl a number of preconception and prenatal provider screenings that had been beforehand provided by way of the demonstration as a part of the basic TRICARE profit.
“Preconception and prenatal carrier screenings help identify people at risk for having children with genetic conditions that may have a high level of death or a shortened life expectancy,” mentioned LaChanda Black, a administration and program analyst with TRICARE Health Plan’s Member Benefits and Reimbursement Section. “Providing families access to these screenings can help them make decisions when planning their family.”
The lab assessments that moved from the LDT demonstration to being a TRICARE coated medical profit embrace one check per situation per lifetime for these particular situations:
- Cystic fibrosis
- Spinal muscular atrophy
- Fragile X syndrome
- Tay-Sachs illness
- Hemoglobinopathies
- Conditions linked with Ashkenazi Jewish descent
TRICARE retroactively accredited these assessments as coated screenings again to Dec. 27, 2021. If you acquired one in every of these provider screening assessments and paid out-of-pocket prices between Dec. 27, 2021 and the brand new coverage begin date of July 19, 2023, name your TRICARE regional contractor. Your regional contractor will walk you thru learn how to submit a declare. You may also request that TRICARE reprocess a denied declare.
If you don’t know the way the claims course of works, you possibly can evaluate step-by-step directions for learn how to file medical claims. Be certain to comply with these steps for simple claims submitting:
- Fill out and signal the Patient’s Request for Medical Payment (DD Form 2642).
- Include a replica of the supplier’s invoice and associated costs paid. You’ll additionally want the sponsor’s Social Security quantity; supplier’s deal with and cellphone quantity; date, location, and outline of service; and analysis, if isn’t on the invoice.
- Mail your declare type to the claims deal with in your claims processor.
- If you’re submitting an abroad declare, you possibly can file your declare on-line.
- Register in your claims processor’s web site to maintain observe of your claims on-line.
- If you’ve questions, attain out to your regional contractor.
You may also go to tricare.mil/comparecosts to search for detailed prices and costs. For further cost and payment data associated to your well being plan, evaluate the TRICARE Costs and Fees Fact Sheet. For extra details about LDTs, you possibly can go to Laboratory Developed Tests.
Would you just like the latest TRICARE information despatched to you by electronic mail? Visit TRICARE Subscriptions, and create your customized profile to get profit updates, information, and extra.
