Transitional Care for Service-Related Conditions

The Transitional Care for Service-Related Conditions (TCSRC) Program extends TRICARE coverage to former active duty, Guard, and Reserve members for certain service-related conditions beyond their regular 180-day TAMP coverage period. The benefit is available worldwide.

Eligibility

If you are eligible for care under TAMP and have a newly-diagnosed medical condition that is related to your active-duty service, you may qualify for an additional 180 days of care for your specified service-related condition. To qualify for TCSRC, your medical condition must be:

  1. Service-related
  2. Newly discovered/diagnosed during the 180-day TAMP period
  3. Able to be resolved within 180 days
  4. Validated by a DoD physician   

Once your medical condition is validated by the DoD, your TCSRC coverage is reflected in the Defense Enrollment Eligibility Reporting System (DEERS).

Benefits

If you qualify, you'll receive medical care for that condition, and that condition only, as if you are still on active duty, with no copayments or cost shares applied.  If you have multiple service-related conditions, each condition will have its own enrollment and coverage period.

TCSRC enrollment includes eligibility for prescriptions necessary to treat the service-related condition(s). You can fill these prescriptions through any of the pharmacy options: military, network, non-network pharmacy, or via home delivery. If you are near a miliary pharmacy, you may want to get your prescriptions filled there.  If not, home delivery is your next best option.

If you use a network or non-network pharmacy during the TCSRC benefit period, you may experience out-of-pocket cost, but be you can file a prescription claim. Be sure to send a copy TCSRC approval letter with your form you will be fully reimbursed for medications related to your TCSRC-authorized condition. TCSRC will not cover the cost of medications unrelated to the treatment of a TCSRC-authorized condition. 

Enrollment into this program does not affect your eligibility for any other TRICARE program for you and your family members. (i.e. Deactivated Guard/Reserve members in the Selected Reserve may enroll in TRICARE Reserve Select and use TCSRC benefits for qualified service-related conditions.)

Getting Started

To see if you qualify for the TCSRC Program, follow these simple steps:

  1. Prepare a letter requesting coverage under the program, and indicate the condition(s) for which you are seeking extended care. Download a Sample Letter. We suggest that you validate with your unit that you show as TAMP-eligible in DEERS. 
  2. Collect copies of all documents showing the condition(s) is/are service-related (please do not send any original documents). Examples include clinical notes from your medical records or a line of duty report.  Other documentation (i.e. medical notes, accident notes, letter/statement from Commanding Officer saying it happened on active duty, etc.) may be considered if the medical condition is not documented in your medical records.
  3. Download the Application Worksheet. Complete your portion of the Application Worksheet and give the Provider Checklist & Instructions to your provider to complete indicating the condition(s) is/are resolvable within 180 days. The doctor who completes the Provider Checklist should be the provider who treats your condition(s). For example, if you are referred by your primary care manager to a specialist for the medical condition, then the specialist should complete the Provider Checklist. See the section below about finding a provider.
  4. Submit your letter with the completed Application Worksheet and all documentation showing the condition is service-related and can be resolved within 180 days to:

Defense Health Agency
Reserve and Service Member Support Office, Great Lakes
320 B Street, Bldg. 38 H
Great Lakes, IL 60088-6999
Fax: 1-866-531-7881

If you have questions about qualifying for TCSRC benefits, contact the Reserve and Service Member Office at 1-888-647-6676 and follow the prompts for assistance. Once the DoD physician validates you are eligible for the TCSRC program, you'll be sent a letter confirming your eligibility.

If you live in the United States, you'll also receive an authorization letter from your regional contractor. The authorization applies to the entire episode of care and expires 180 days after the DoD physician's date of validation.

If you live overseas, contact your TRICARE Area Office (TAO) to get specific information about your benefits and coverage. 

  • TAO Eurasia-Africa: 0049-6371-9464-2999
  • TAO Latin America & Canada: 1-210-292-8520
  • TAO Pacific: +81-98-970-9155

Finding a Provider

Any provider (military, network or non-network) can complete the Provider Checklist portion of Application Worksheet. When approved, this is most likely the same doctor who will provide the care for your medical condition during the 180-day TCSRC coverage period. 

If you live near a military hospital or clinic, try to get care there. If note, we recommend you visit a network provider, if one is available. Visit your region's network provider directory, listed below, to find a network provider near you or contact your regional contractor for assistance.

If a network provider is not available, you may visit a TRICARE-authorized, non-network provider. In some cases, you may have to pay up front for care and file a claim for reimbursement. Be sure to always include a copy of your TCSRC approval letter when filing a TCSRC claim. Send your claims to your regional contractor at one of the following addresses:

North Health Net Federal Services, Inc.
c/o PGBA, LLC/TRICARE
P.O. Box 870140
Surfside Beach, SC 29587-9740
South  TRICARE South Region
Claims Department
P.O. Box 7031
Camden, SC 29020-7031
West  TRICARE West Region
Claims Department
P.O. Box 7064
Camden, SC  29020-7064

Overseas Providers

If a military hospital or clinic is not available overseas, you may visit any host-nation provider. The overseas contractor, International SOS, has established a network of qualified providers in all overseas areas. For assistance finding an overseas provider:

In most cases overseas, you'll need to pay up front for the care and submit paper claims for reimbursement. Be sure to always include a copy of your approval letter when filing TCSRC claims. Send your claims to the following address from all overseas areas:

WPS - Active Duty Claims Processing
P.O. Box 7968
Madison, WI 53707-7968

If You Don't Qualify

If you have a service-related condition that cannot be resolved within the 180-day TCSRC period and therefore cannot be approved for the TCSRC Program, you may be eligible to receive medical care for this condition through the Department of Veteran's Affairs (VA). The VA determines eligibility for VA benefits; call 1-877-222-8387 or visit www.va.gov for more information. Additionally, if you are currently in the National Guard or Reserves, you may want to contact your unit to see if you qualify for line of duty benefits. 

If you have additional information from your provider that supports his/her belief that your condition can be resolved within 180 days, you may request reconsideration of your application in writing within 30 days of the date of this letter. Supporting documentation and requests for reconsideration may be sent by fax or mail to:

Defense Health Agency
Reserve and Service Member Support Office, Great Lakes
320 B Street, Bldg. 38 H
Great Lakes, IL 60088-6999

Fax: 1-866-531-7881

Last Updated 12/4/2013