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Defense Health Care: DOD Needs to Improve its Monitoring of Claims Processing Activities
DOD's primary medical mission is to maintain the health of 1.6 million active duty service personnel and to provide health care for them during military operations. DOD additionally offers health care to 6.6 million nonactive duty beneficiaries, including dependents of active duty personnel, military retirees, and dependents of retirees. Most health care is provided in military-operated hospitals and clinics worldwide and is supplemented by care provided by civilian providers under TRICARE. TRICARE is a triple-option benefit program designed to give beneficiaries a choice among a health maintenance organization, a preferred provider organization, and a fee-for-service benefit. The health maintenance organization option, called TRICARE Prime, is the only option for which beneficiaries must enroll. TRICARE Extra is the preferred provider organization option, and TRICARE Standard is the fee-for-service option.
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