The Third Party Collection program was legislated by Congress in 1986. It obligates Department of Defense Military Treatment Facilities to bill private health insurance carriers such as Blue Cross/Blue Shield, Mail Handlers, Aetha, etc., for the cost of medical care furnished to retirees and family members covered by their own healt insurance policies. This includes all medical benefits and ancillary services such as pharmacy items.
Private health insurance policies are billed, that is why we use the term "Third Party." MTFs can only collect for services covered by your third party health insurance plan according to your benefits with the plan.
By law, your insurance policy rates cannot go up or be canceled just because a claim is filed. Health insurance in not like automobile insurance, your rates will not go up when you file a claim.
Other Health Insurance Card
The yellow Other Health Insurance (OHI) card is our way of easily ensuring that the DD Form 2569 has been completed without the inconvenience of having you, our patient, fill out a new form each time a visit is made within the facility. The form is filled out once a year, or more often if you have an inpatient stay, any ambulatory procedure visit (outpatient surgery) or a change in your insurance status. Per DoD Instruction 6010.15m Chapter 4, all non-active duty beneficiaries are required to fill out a DD Form 2569, whether or not they have OHI.
Please present your card at the time of check-in at each patient intake area where you are seeking health care services. The OHI card is valid for one year, if information remains the save. A new DD Form 2569 will need to be completed when your expiration date is reached. This expiration information is listed on the card for your convenience.
Yellow OHI cards can be issued by the TPC Representative or MTF personnel at the facility where you receive your health care.
We Understand!
Health care is expensive and costs are continuously rising. The law requires all MTFs to recover some of these costs if you are covered by a civilian insurance company. We understand that health care is an earned service benefit. Billing your private insurance carrier will help us offset the cost of care and allow for improvements to the quality of care you receive at the MTF.
How the TPC program benefits you
- Most insurance plans have a deductible that must be met before the plan begins to pay. Costs for services billed by the MTF will be applied toward your deductible. This means you may pay less out-of-pocket expense when later seeking health care through a civilian provider.
- You also benefit from the TPC program because the MTF that collects the money uses the insurance reimbursements to enhance their services for you.
You will NOT be billed for the difference!
Whatever your insurance company pays is considered "payment in full." We will never bill you for any co-pays, deductibles, or care that your insurance does not cover.
While you may occasionally receive an Explanation of Benefits (EoB) from your health insurance carrier reflecting a balance is owed, you are never responsible for paying that balance to the medical treatment facility. This is not a Bill. . .It is merely an explanation for your personal records. If you have questions, we encourage you to call our OHI hotline.
Help Us Help You!
The TPC program only works if we have current and accurate information for other health insurance policies you carry. When you visit your military treatment facility, you will be asked to provide other health insurance information. Please help us help you by filling in the requested information.