Tricare and You – Reservists injured or ill while on orders

This blog is the most recent in a series helping members of the Coast Guard family understand how to use their TRICARE benefits. The blog series will continue every Monday, right here on Coast Guard All Hands.

Written by Cmdr. Paul Fawcett, chief of Medical Administration for Coast Guard’s Office of Health, Safety and Work-Life

When a Coast Guard Reserve member is performing inactive duty for training (IDT), active duty for training (ADT) or any other form of military orders, they are eligible for health care for the period of their service. This health care includes readiness items such as mandatory periodic health assessments (PHA), required dental exams and cleanings and care for injuries or illness sustained while on duty.

What to do if you are injured or become ill while on orders

If you are operating on military orders and become ill or injured, report it to your military supervisor and seek medical care from your servicing Coast Guard clinic or from civilian providers depending on your circumstances. It is essential you report injuries or illnesses incurred on duty before you complete your drill or orders. Otherwise it may not be possible to connect your condition to service, resulting in a potential loss of benefits.

Once you have received initial military treatment you will be evaluated to determine if you need additional care.

Continuing medical care for injured or ill Reservists

If you incurred a service related condition while on IDT or ADT orders, you may be eligible for continued medical care for that condition. Your condition must be determined to be in the line of duty and not as a result of misconduct. Your local command will make that determination.

Depending on your circumstances and condition, you may be retained on active duty during the period of treatment or recovery for an illness or injury incurred or aggravated while on active duty. In this case pay and allowances continue as well as funded medical care. This administrative tool is called Medical Hold or Active Duty for Health Care. The Reserve Policy Manual, COMDTINST 1001.28C specifies the provisions of these tools.

Notice of Eligibility

If you become injured or ill while executing orders, but aren’t retained on Medical Hold, you may be issued a Notice of Eligibility (NOE). A NOE authorizes you funded medical care specifically for, and only for, your service related condition. These medical benefits may be provided via the TRICARE network or from a military treatment facility. The funded care does not extend to family members and is for a defined period to return the member to fully fit for duty or determine that they must enter the medical board process if they are unable to become fit for full duty.

Medical Records

While receiving care for your service related condition, it’s critical that all treatment and incidents of care become documented in your Coast Guard medical record. You should not assume that your providers will automatically send it to your servicing clinic. Ask them to do so and provide them with a fax number of your clinic or medical record custodian. These records may be key to determining future eligibility for benefits.

For TRICARE issues you may also contact the CG health benefits assistance line at 1-800-9-HBA-BBA or at CGHBA@uscg.mil.

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