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The RAUS Group Tricare Supplement
Available to all CHAMPUS/CHAMPVA eligible recipients
(E-1 through O-10) regardless of service!
Select the Plan Option That
Meets Your Needs
Get the protection you need a a price you can
afford.
The TRICARE Extra, Standard Supplement gives you
the choice of two options: the Comprehensive
Plan or the High
Option II Plan. Both options provide benefits to help pay your TRICARE
cost share for in-hospital and outpatient care, doctor visits, emergency
room care, prescription medications, and much more.
Both options also pay 100% of covered excess charges up
to the reasonable and customary standard level, not the 115% legal limit
cap imposed by Tricare. The
Comprehensive Plan has a new survivor benefit that pays the premium of the
surviving spouse and covered dependents up to one year.
The High Option plan has a fiscal year Plan Deductible
of $150 per person and $300 family maximum.
The Comprehensive Plan also reimburses the Tricare
fiscal year outpatient deductible subject to a modest fiscal year Plan
Deductible of $75 per person and $150 per family.
There is also a plan for Dependents of Active Duty
Members.
Eligibility
You are eligible to enroll provided you are
eligible TRICARE/CHAMPVA recipient, under age 65, and entitled to
retired, retainer, or equivalent pay. If you are age 65 or over and
ineligible for Medicare, you may apply for the plan by attaching a copy of
your Social Security Notice of Disallowance of Benefits to your Enrollment
Form.
Coverage is also available for your Tricare-eligible
spouse under age 65 and dependant, unmarried children under age 21 (23 if in college).
Eligible spouses and children of active-duty members are may enroll; Tricare-eligible
widow(er)s and ex-spouses may also enroll.
Waiver of Premium for Surviving Spouse
and Dependents
The Comprehensive Plan features a special
benefit that provides additional financial protection to your surviving
spouse and dependents. If you die while insured under the Plan, your insured
spouse's premiums will be waived for up to one full year unless your spouse
remarries, reaches 65, or dependents no longer remain in an eligible status.
After a year, he or she will need to begin paying the appropriate premium to
continue coverage.
Effective Date
Your coverage and that of your covered dependants becomes effective on the first day of the month
following receipt of your Enrollment Form and the first premium payment. If, on that day, you or a covered dependent are confined in
a hospital, the effective date will be the day following discharge from the hospital.
Renewability
Your coverage is renewable to age 65. As long as
premiums are paid on time; you remain a member of RAUS; you, your spouse
and dependents remain in an eligible status (you are covered by
Tricare , children are under age 21 or
23 if a full-time student); and the Master Policy and your class of
insured persons remain in effect. So even if you or a covered dependent
develops a serious health condition in the future, their coverage will not
terminate, provided these conditions are met. Under the Comprehensive
Plan, your insured dependent's premium will be waived for up to one year,
if you die while insured. To continue coverage beyond one year, your
surviving spouse must pay the appropriate premium.
Exclusions
Treatment or confinement not ordered by a physician or necessary
for medical care; intentionally self-inflicted injuries; suicide or attempted suicide
while sane or insane; sickness or injury resulting from acts of war, whether
declared or
undeclared;
routine physical exams, eye exams, eye refractions and immunizations, except for well baby care covered by
Tricare; custodial care, hearing aids, orthopedic footwear; eyeglasses or
contact lenses; cosmetic procedures, except those resulting from sickness or
injury occurring while a covered person; drugs (other than insulin) which
do not require a prescription; any confinement, service or supply not
covered under Tricare, or for expenses paid in full by
Tricare;
expenses in excess of the Tricare
Cap; the Tricare
Standard/Extra fiscal year outpatient deductible, except as specifically
provided under the comprehensive plan; care of the mentally
retarded or physically handicapped which is required due to the mental
retardation or physical handicap; any part of a covered expense which the
covered Person is not legally obligated to pay because of payment by a Tricare alternative program.
Limitations
Routine newborn and well baby care, hospital
nursery charge for a well newborn, dental care, treatment for prevention or cure of alcoholism or drug
addiction, and prosthetic devices are limited to expenses covered by Tricare.
INPATIENT treatment for mental, nervous, or emotional disorders in excess
of 45 days if under age 19, or 30 days if age 19 or older, is limited to 90 days
(if approved by Tricare) in a calendar year. OUTPATIENT benefits
for mental, nervous or emotional disorders, drug addiction or alcoholism
are limited to a maximum of $500 in a 12-month period.
Pre-Existing Limitations
Any injury or sickness, whether diagnosed or
undiagnosed, for which a covered person received medical care or treatment
within the 12-month period (6 months in California and Indiana) preceding the effective date of his or her
insurance will not be covered until they have been without medical care or
treatment for that condition for 12 consecutive months (6 consecutive
months in California) ending on or after
the effective date of their coverage, or after 24 months (12 months in
Indiana, North and South Carolina and Wisconsin; 6 months in California) following the
effective date of their coverage, whichever occurs first. However, new
conditions will be covered immediately.
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IMPORTANT NOTICE
ASI is pleased to announce that
negotiations with the Hartford Life Insurance Company have
resulted in a liberalization of the Pre-Existing Condition
Limitations Provision in our Tricare
Supplement Program.
Please refer to the paragraph: PRE-EXISTING
LIMITATIONS above. The former provision required a
twelve-month waiting period before payment for a covered claim
could be made for a pre-existing condition.
The new provision applies to claims “incurred” on or
after October 1, 2006.
The new Pre-existing Condition Limitations is one of
the most favorable in the Tricare
Supplement market place and we are pleased to be able to make it
available to you. |
To download/view Pre-Existing Condition Plan
Enhancements (Effective October 1, 2004) in the Adobe Acrobat PDF format,
click here. If you do not have the
current Acrobat Reader software, you may obtain it FREE
from Adobe's web site. Click on the following link
to go there.
| Guaranteed Acceptance
- Satisfaction Guaranteed It's easy to enroll in the Tricare
Extra Standard Supplement Plan. Just complete the Enrollment Form -
making sure to provide all information requested - and return it with
your check for the first premium payment. That's all there is to it! You
cannot be turned down for coverage, although a pre-existing condition
may initially limit the extent of your coverage. After your completed
enrollment form and first premium payment have been processed, you'll
receive a certificate of insurance which you can examine for 30 days
risk free. Return it for a full refund if you are not completely
satisfied. |
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To download and print the complete insurance plan,
coverage, rates and necessary forms (including the RAUS Membership
Application) in Adobe Acrobat PDF format,
click here. |
For more about Tricare Supplement Insurance, select:
[ The Plan | Coverage |
Group Rates |
About Us |
Enrollment ]
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