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VA & Tricare
                                    Newsletter

MAY 17, 2012                                                             VOLUME 1, NUMBER 67
                                    A LOOK AT ACTIVE DUTY DENTAL PROGRAM

                                    The Active Duty Dental Program (ADDP) is program that
                                    does dental claims processing. Its purpose is to
                                    augment-not replace- dental care that is provided by
                                    Military Dental Treatment Facilities (DTF’s). There are
                                    two distinct components one is DTF referred and Remote
                                    Active Duty Dental Program (RADDP). Authorized users
                                    will be required to use a United Concordia network
                                    dentist, unless otherwise designated by United
                                    Concordia.
               Websites:            Who is eligible?
               ADDP Website:              Active Duty Personnel of 5 uniformed services
                                          who live and work within 50 miles of a military
               www.addp-ucci.com
                                          DTF
                Customer Service:         Guardsmen and Reservists on orders >30 days
                1-866-984-2337            Foreign military personnel stationed in the U.S.
                                          Early Activators/delayed effective date active
                                          orders
                                          Line of Duty Personnel
                                          Service members on TAMP that came off orders
                                          in support contingency operation (ex. OEF/OIF,
                                          Operation Dawn)
                                    Program Components
                                          DTF referred care – provides private sector
                                          dental care for ADSMs referred for private sector
                                          dental care from a military DTF. Included are
                                          ADSMs who have a duty location or residence
                                          with 50 miles of a DTF.
                                          Remote ADDP – provides private sector dental
                                          care for ADSMs with a duty location and
                                          residence greater than 50 miles from a military
DTF.
Referrals/Authorizations
United Concordia is required to track all referrals and
authorizations for the ADDP. Referrals are made by a
military DTF for care not available in that DTF. Remote
ADSMs may personally coordinate their own routine care
if all guidelines are followed. Authorizations are
submitted from a civilian provider for remote ADSM
specialty and other care.
      DTF Referral – When an ADSM requires dental
      care that cannot be provided by the DTF, the DTF
      will prescribe a referral (that the ADSM will bring
      to the civilian network dentist appointment). The
      DTF referral should be accepted as a treatment
      plan, which is indicated on the referral form.
      However, if the civilian dentist finds clinical
      reasoning for alternative treatment, a modified
      referral is required. Referral modifications are
      obtained by contacting the DTF.
      Remote ADDP Self-Referrals – Remote ADSMs
      self-refer for routine covered benefits (non-
      specialty dental care such as examinations,
      cleanings, fillings), unless that care is over $500
      per appointment or cumulative total of $1500 or
      more for treatment plans completed within a
      consecutive 12 month period. Remote ADSMs
      cannot self-refer for any specialty procedures,
      regardless of cost. Remote ADSMs must use a
      United Concordia network dentist and obtain an
      Appointment Control Number (ACN) from United
      Concordia prior to scheduling any private sector
      dental appointment. To coordinate routine dental
      care, remote ADSMs must complete an
      Appointment Request Form (available at
      www.addp-ucci.com). United Concordia will
      provide the remote ADSM with a CAN after form
      submission.
      Remote ADDP Authorization – Authorizations
      are required for all care for which the remote
      ADSM cannot self-refer. A civilian dentist will
      request an authorization for a remote ADSM
      using the Authorization Request Form (available
      at www.addp-ucci.com). This form must indicate
      the procedures desired in order to initiate the
      authorization request. Upon authorization
      approval, the remote ADSM and civilian dentist
      will be notified and an appointment can be
scheduled to initiate care. The determination of
       the authorization request can take from to three
       to five business days.
If you are requiring more information on this program
please go to the website: www.addp-ucci.com .
To Contact United Concordia ADDP, you can contact by
email, mail or phone. It is as follows:
United Concordia Companies, Inc.
ADDP Unit
PO Box 69430
Harrisburg, PA 17106-9430
Email: addpdcf@ucci.com
Phone: 1-866-984-2337
Source: Tricare Active Duty Dental Program Website
VA Benefits
HEALTH BENEFITS ADVISOR
                                             Traumatic Service member’s Group Life Insurance
Amador ―Rod‖ Rodriguez
678-569-7174                                 (TSGLI)
amador.rodriguezjr@us.army.mil
                                             Traumatic Service member’s Group Life Insurance is a
                                             Congressionally-mandated insurance program that
              OR                             provides short-term financial support to traumatically
           Transition Assistant Advisor
                                             injured Soldiers and their families through a one-time
           (TAAs) Marvin Thomas/Darrell      payment effective December 1, 2005. TSGLI is bundled
           Partee                            with SGLI- premium was increased by $1 to
                                             accommodate traumatic coverage. TSGLI provides
           The TAA is the TRICARE and
           VA liaison for the state.         payments of $25,000 up to $100,000 to members of the
                                             uniformed services covered by SGLI who sustain certain
           Assistance provided for:          specified losses as a result of a traumatic injury. Like
                   TRICARE for Life          SGLI, TSGLI covers a service member 24/7.

                   TRICARE Reserve           How TSGLI helps injured Soldiers
                   Select
                                             TSGLI is designed to assist with unanticipated expenses
                   TRICARE Retired           and/or help with a head start on life after recovery.
                   Reserve                   Payment amount varies depending on the injury. Free
                                             financial counseling is available for Soldiers from
                   TRICARE Dental,
                   Active Duty Dental        Financial Point. TSGLI is a one-time financial
                                             assistance—NOT income replacement. TSGLI does not
                   VA Services and           replace any other VA benefits.
                   Benefits
                                             Who Is Eligible For TSGLI
                   Filing assistance for
                   benefits with VA, DOD     Soldiers who elect Service members Group Life
                   and Tricare
                                             Insurance (SGLI) coverage and incur a qualifying
                   The TAA is available*     traumatic injury after 1 December 2005, regardless of
                   to provide in-person      their component (Active, Reserve or National Guard) or
                   briefings for TRICARE
                   and/or VA benefits.       the location in which they incurred the injury. Survivors
                   (Available during drill   of service members who died more than seven days
                   weekends)                 after their injuries are also eligible to receive TSGLI
                                             payment if the member had a covered loss.

                                             Retroactive TSGLI

                                             As of October 1, 2011, the Service members’ Group Life
                                             Insurance Traumatic Injury Protection Benefit will be
                                             payable for all qualifying injuries incurred during the
                                             period October 7, 2001 to November 30, 2005,
                                             regardless of where they occurred and regardless of
                                             whether the member has SGLI coverage at the time of
                                             the injury. The Veterans’ Benefit Act of 2010 removes
                                             the requirement that injuries during this period be
                                             incurred in Operations Enduring or Iraqi Freedom.

                                             Applications for the retroactive TSGLI can be accepted
by the Branch of Services TSGLI Offices, benefits will not
CONTACT:
                                        be paid until October 1, 2011, the effective date of the
Mr RODRIQUEZ (address shown above)      law.

           OR                           A Qualifying Traumatic Injury is an injury or loss
                                        caused by application of external force or violence (a
•   MARVIN THOMAS
                                        traumatic event) OR a condition whose cause can be
•   OFFICE 678-569-8193                 directly linked to a traumatic event. Examples would be
                                        loss of hand or foot by severance at or above the wrist
•   BB: 678-656-4115                    or ankle; loss of speech, or paraplegia.

•   marvin.w.thomas@us.army.mil         Claim Process

•   www.facebook.com/MarvinThomasTAA    Obtain a TSGLI Claim form by downloading a claim form
                                        with complete information packet from this website
•   CONTRACTOR
                                        www.insurance.va.gov, or
•   SKYLINE-Ultd                        http://www.insurance.va./gov/sgliSite/TSGLI/TSGLI.htm
                                        then submit to your branch of service point of contacts:
•   DARRELL PARTEE
                                        Army (All Components) – Phone (800) 237-1336, Fax
•   OFFICE 478-803-3149
                                        (502) 613-4513, email: tsgli.calims@conus.arm
•   BB: 404-840-5792
                                        Navy (All Components) – Phone (800) 368-3202, Fax
•   darrell.partee@us.army.mil          (901) 874-2265 , email: MILL_TSGLI@navy.mil

•   www.facebook.com/DarrellParteeTAA   Air Force – Phone (800) 433-0048, Fax (210) 565-2348,
                                        email: afpc.casualty@randolph.af.mil
•   CONTRACTOR
                                        Air Reserve – Phone (800) 525-0102, Fax (303) 676-
    SKYLINE-Ultd                        6255, email: afpc.dppedl@arpc.denver.af.mil

                                        Air National Guard - Phone (703) 607-5093, Fax (703)
                                        607-0033, email: ngb.a1ps@ang.af.mil

                                        Marine Corps (All Components) – Phone (877) 216-0825
                                        or (703) 432-9277, Fax (888)858-2315, email: t-
                                        sgil@usmc.mil

                                        Coast Guard – Phone (202) 493-1931, Fax (202) 493-
                                        1939, email: ARL-PF-CGPSC-PSDFS-
                                        COMPENSATION@uscg.mil

                                        Public Health Service - Phone (301) 594-2963, Fax
                                        (301)594-2973, email:
                                        compensationbranch@psc.hhs.gov

                                        NOAA Corps – Phone (301) 713-3444, Fax (301) 713-
                                        4140, email: Director.cpc@noaa.gov

                                        Source: VA website and VA news release
SERVING WOUNDED WARRIORS AND THE SURVIVORS
OF OUR FALLEN HEROES

 BY Gina Ramer, Regional Communications Director,
Social Security Administration

It’s an American tradition to pay tribute to the men and
women of the Armed Forces each Memorial Day —
especially honoring those who have made the ultimate
sacrifice while serving our country.

If you are a military service member who was wounded
and needs to apply for Social Security disability benefits,
it’s important to know that you will receive expedited
processing. Our wounded warrior’s initiative is for
military service members who become disabled while on
active duty on or after October 1, 2001, regardless of
where the disability occurs. Depending on the situation,
some family members of military personnel, including
dependent children and, in some cases, spouses, may be
able to receive benefits. Learn more about it at
www.socialsecurity.gov/woundedwarriors.

 Did you know that May also is National Military
Appreciation Month? Even more reason to let members
of our military know how much we value what you do for
us and our nation. To learn more about the Social
Security benefits for those who have served in the
military, read our publication, Military Service and Social
Security. You can find it online at
www.socialsecurity.gov/pubs/10017.html, or send us an
email at OPI.Net.Post@ssa.gov, or call us at 1-800-772-
1213 (TTY 1-800-325-0778) to ask for a free copy to be
mailed to you.

 Memorial Day also is a good time to remind families of
fallen military heroes that we may also be able to pay
Social Security survivors benefits. If the person you
depended on for income has died, you should apply for
survivors benefits. Learn more about Social Security
survivors benefits at
www.socialsecurity.gov/pgm/survivors.htm .
The men and women of the Armed Forces serve us each
    and every day. At Social Security, we’re here to serve
    you too.



    Watch out for the June newsletter which will contain
    information about Line of Duty and Guide and Service
    Dogs. The newsletter can be found on the TAA face book
    page www.facebook.com/USATAA

     If there is any material on Tricare, VA or DoD program
    you would like to see me address in my next newsletter
    please feel free to contact us using our email address
    listed above.




1

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TAA May 2012 Newsletter

  • 1. VA & Tricare Newsletter MAY 17, 2012 VOLUME 1, NUMBER 67 A LOOK AT ACTIVE DUTY DENTAL PROGRAM The Active Duty Dental Program (ADDP) is program that does dental claims processing. Its purpose is to augment-not replace- dental care that is provided by Military Dental Treatment Facilities (DTF’s). There are two distinct components one is DTF referred and Remote Active Duty Dental Program (RADDP). Authorized users will be required to use a United Concordia network dentist, unless otherwise designated by United Concordia. Websites: Who is eligible? ADDP Website: Active Duty Personnel of 5 uniformed services who live and work within 50 miles of a military www.addp-ucci.com DTF Customer Service: Guardsmen and Reservists on orders >30 days 1-866-984-2337 Foreign military personnel stationed in the U.S. Early Activators/delayed effective date active orders Line of Duty Personnel Service members on TAMP that came off orders in support contingency operation (ex. OEF/OIF, Operation Dawn) Program Components DTF referred care – provides private sector dental care for ADSMs referred for private sector dental care from a military DTF. Included are ADSMs who have a duty location or residence with 50 miles of a DTF. Remote ADDP – provides private sector dental care for ADSMs with a duty location and residence greater than 50 miles from a military
  • 2. DTF. Referrals/Authorizations United Concordia is required to track all referrals and authorizations for the ADDP. Referrals are made by a military DTF for care not available in that DTF. Remote ADSMs may personally coordinate their own routine care if all guidelines are followed. Authorizations are submitted from a civilian provider for remote ADSM specialty and other care. DTF Referral – When an ADSM requires dental care that cannot be provided by the DTF, the DTF will prescribe a referral (that the ADSM will bring to the civilian network dentist appointment). The DTF referral should be accepted as a treatment plan, which is indicated on the referral form. However, if the civilian dentist finds clinical reasoning for alternative treatment, a modified referral is required. Referral modifications are obtained by contacting the DTF. Remote ADDP Self-Referrals – Remote ADSMs self-refer for routine covered benefits (non- specialty dental care such as examinations, cleanings, fillings), unless that care is over $500 per appointment or cumulative total of $1500 or more for treatment plans completed within a consecutive 12 month period. Remote ADSMs cannot self-refer for any specialty procedures, regardless of cost. Remote ADSMs must use a United Concordia network dentist and obtain an Appointment Control Number (ACN) from United Concordia prior to scheduling any private sector dental appointment. To coordinate routine dental care, remote ADSMs must complete an Appointment Request Form (available at www.addp-ucci.com). United Concordia will provide the remote ADSM with a CAN after form submission. Remote ADDP Authorization – Authorizations are required for all care for which the remote ADSM cannot self-refer. A civilian dentist will request an authorization for a remote ADSM using the Authorization Request Form (available at www.addp-ucci.com). This form must indicate the procedures desired in order to initiate the authorization request. Upon authorization approval, the remote ADSM and civilian dentist will be notified and an appointment can be
  • 3. scheduled to initiate care. The determination of the authorization request can take from to three to five business days. If you are requiring more information on this program please go to the website: www.addp-ucci.com . To Contact United Concordia ADDP, you can contact by email, mail or phone. It is as follows: United Concordia Companies, Inc. ADDP Unit PO Box 69430 Harrisburg, PA 17106-9430 Email: addpdcf@ucci.com Phone: 1-866-984-2337 Source: Tricare Active Duty Dental Program Website
  • 4. VA Benefits HEALTH BENEFITS ADVISOR Traumatic Service member’s Group Life Insurance Amador ―Rod‖ Rodriguez 678-569-7174 (TSGLI) amador.rodriguezjr@us.army.mil Traumatic Service member’s Group Life Insurance is a Congressionally-mandated insurance program that OR provides short-term financial support to traumatically Transition Assistant Advisor injured Soldiers and their families through a one-time (TAAs) Marvin Thomas/Darrell payment effective December 1, 2005. TSGLI is bundled Partee with SGLI- premium was increased by $1 to accommodate traumatic coverage. TSGLI provides The TAA is the TRICARE and VA liaison for the state. payments of $25,000 up to $100,000 to members of the uniformed services covered by SGLI who sustain certain Assistance provided for: specified losses as a result of a traumatic injury. Like TRICARE for Life SGLI, TSGLI covers a service member 24/7. TRICARE Reserve How TSGLI helps injured Soldiers Select TSGLI is designed to assist with unanticipated expenses TRICARE Retired and/or help with a head start on life after recovery. Reserve Payment amount varies depending on the injury. Free financial counseling is available for Soldiers from TRICARE Dental, Active Duty Dental Financial Point. TSGLI is a one-time financial assistance—NOT income replacement. TSGLI does not VA Services and replace any other VA benefits. Benefits Who Is Eligible For TSGLI Filing assistance for benefits with VA, DOD Soldiers who elect Service members Group Life and Tricare Insurance (SGLI) coverage and incur a qualifying The TAA is available* traumatic injury after 1 December 2005, regardless of to provide in-person their component (Active, Reserve or National Guard) or briefings for TRICARE and/or VA benefits. the location in which they incurred the injury. Survivors (Available during drill of service members who died more than seven days weekends) after their injuries are also eligible to receive TSGLI payment if the member had a covered loss. Retroactive TSGLI As of October 1, 2011, the Service members’ Group Life Insurance Traumatic Injury Protection Benefit will be payable for all qualifying injuries incurred during the period October 7, 2001 to November 30, 2005, regardless of where they occurred and regardless of whether the member has SGLI coverage at the time of the injury. The Veterans’ Benefit Act of 2010 removes the requirement that injuries during this period be incurred in Operations Enduring or Iraqi Freedom. Applications for the retroactive TSGLI can be accepted
  • 5. by the Branch of Services TSGLI Offices, benefits will not CONTACT: be paid until October 1, 2011, the effective date of the Mr RODRIQUEZ (address shown above) law. OR A Qualifying Traumatic Injury is an injury or loss caused by application of external force or violence (a • MARVIN THOMAS traumatic event) OR a condition whose cause can be • OFFICE 678-569-8193 directly linked to a traumatic event. Examples would be loss of hand or foot by severance at or above the wrist • BB: 678-656-4115 or ankle; loss of speech, or paraplegia. • marvin.w.thomas@us.army.mil Claim Process • www.facebook.com/MarvinThomasTAA Obtain a TSGLI Claim form by downloading a claim form with complete information packet from this website • CONTRACTOR www.insurance.va.gov, or • SKYLINE-Ultd http://www.insurance.va./gov/sgliSite/TSGLI/TSGLI.htm then submit to your branch of service point of contacts: • DARRELL PARTEE Army (All Components) – Phone (800) 237-1336, Fax • OFFICE 478-803-3149 (502) 613-4513, email: tsgli.calims@conus.arm • BB: 404-840-5792 Navy (All Components) – Phone (800) 368-3202, Fax • darrell.partee@us.army.mil (901) 874-2265 , email: MILL_TSGLI@navy.mil • www.facebook.com/DarrellParteeTAA Air Force – Phone (800) 433-0048, Fax (210) 565-2348, email: afpc.casualty@randolph.af.mil • CONTRACTOR Air Reserve – Phone (800) 525-0102, Fax (303) 676- SKYLINE-Ultd 6255, email: afpc.dppedl@arpc.denver.af.mil Air National Guard - Phone (703) 607-5093, Fax (703) 607-0033, email: ngb.a1ps@ang.af.mil Marine Corps (All Components) – Phone (877) 216-0825 or (703) 432-9277, Fax (888)858-2315, email: t- sgil@usmc.mil Coast Guard – Phone (202) 493-1931, Fax (202) 493- 1939, email: ARL-PF-CGPSC-PSDFS- COMPENSATION@uscg.mil Public Health Service - Phone (301) 594-2963, Fax (301)594-2973, email: compensationbranch@psc.hhs.gov NOAA Corps – Phone (301) 713-3444, Fax (301) 713- 4140, email: Director.cpc@noaa.gov Source: VA website and VA news release
  • 6. SERVING WOUNDED WARRIORS AND THE SURVIVORS OF OUR FALLEN HEROES BY Gina Ramer, Regional Communications Director, Social Security Administration It’s an American tradition to pay tribute to the men and women of the Armed Forces each Memorial Day — especially honoring those who have made the ultimate sacrifice while serving our country. If you are a military service member who was wounded and needs to apply for Social Security disability benefits, it’s important to know that you will receive expedited processing. Our wounded warrior’s initiative is for military service members who become disabled while on active duty on or after October 1, 2001, regardless of where the disability occurs. Depending on the situation, some family members of military personnel, including dependent children and, in some cases, spouses, may be able to receive benefits. Learn more about it at www.socialsecurity.gov/woundedwarriors. Did you know that May also is National Military Appreciation Month? Even more reason to let members of our military know how much we value what you do for us and our nation. To learn more about the Social Security benefits for those who have served in the military, read our publication, Military Service and Social Security. You can find it online at www.socialsecurity.gov/pubs/10017.html, or send us an email at OPI.Net.Post@ssa.gov, or call us at 1-800-772- 1213 (TTY 1-800-325-0778) to ask for a free copy to be mailed to you. Memorial Day also is a good time to remind families of fallen military heroes that we may also be able to pay Social Security survivors benefits. If the person you depended on for income has died, you should apply for survivors benefits. Learn more about Social Security survivors benefits at www.socialsecurity.gov/pgm/survivors.htm .
  • 7. The men and women of the Armed Forces serve us each and every day. At Social Security, we’re here to serve you too. Watch out for the June newsletter which will contain information about Line of Duty and Guide and Service Dogs. The newsletter can be found on the TAA face book page www.facebook.com/USATAA If there is any material on Tricare, VA or DoD program you would like to see me address in my next newsletter please feel free to contact us using our email address listed above. 1