Member  
 Handbook
   Welcome. 
   We’re honored that you’ve selected 
   US Family Health Plan for your 
   TRICARE benefits. Over the years, 
   we’ve earned high marks from our 
   members for the quality of care and 
   service we provide. The help starts 
   here — with our Member Handbook.
    Important Phone Numbers
    Emergency
    If you have a medical emergency, call 911 or go to the nearest hospital  
    emergency room immediately. Then call your primary care provider (PCP)  
    within 24 hours. (Your PCP’s name and phone number are on the front of  
    your US Family Health Plan member ID card.)
    Member Services
    1.800.818.8589 
    For questions about your benefits, authorizations, claims, or billing status.
    Appointments, Referrals, Authorizations for Urgent Care 
    Call your primary care provider (PCP). (Your PCP’s name and phone number 
    are on the front of your US Family Health Plan member ID card.)
    Pharmacy
    Home Delivery pharmacy 
    1.877.880.7007
    Brighton Marine pharmacy 
    617.562.5304
    24-Hour Nurse Advice Line
    1.866.767.4546
    When you need answers to basic health questions (Does my cut need  
    stitches? Should I worry about this rash?), registered nurses are available  
    by phone every day, all day and night.
    Mental-Health and Substance-Abuse Self-Referrals
    1.800.208.9565
    Provides you with a list of mental-health professionals affiliated with  
    US Family Health Plan. (Administered by Tufts Health Plan.)
    Defense Enrollment Eligibility Reporting System (DEERS) 
    1.800.538.9552
    Website and Secure Member Portal 
    usfamilyhealth.org
    The latest information about US Family Health Plan, including a list of  
    network providers. You also register here for our Secure Member Portal,  
    which lets you review benefit information and view claims, referrals,  
    and authorizations.
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          Contents
          Summary of Benefits .......................4                Your Benefits and  
                                                                      How to Use Them ...........................14
          Your US Family Health Plan                                    Copayments
          Member ID Card ................................6              Emergency care
           If you lose your card                                        Urgent care/after-hours care ........15
           If you change your primary care 
           provider (PCP)                                                                                   ®
                                                                        Telehealth from Teladoc  ...............16
           If you update your DEERS                                     Routine care
           information                                                  You and your primary care provider
          Enrollment ...........................................7       In-area coverage .............................17
           Enrollment eligibility                                       Referrals to specialists 
           New enrollments ...............................8             Managing your referrals .................18
           If you are an inpatient                                      Mental-health and substance-
           Newborns and adoptees .................9                     abuse self-referrals .........................19
           Military hospitals or clinics                                Inpatient skilled nursing care .......20
           Maintaining enrollment/                                      Point of Service option
           Lifetime members                                             24-Hour Nurse Advice Line ..........21
           Enrollment transfer .........................10              Vision care
           Enrollment fee                                               Hearing-aid coverage for active-
           Split-family enrollment ...................11                duty family members ......................22
           Keeping your enrollment                                      Durable medical equipment
           information up to date                                       Hospice care ....................................23
           Updating DEERS
           If you move within our                                     Prescriptions .....................................24
           service area                                                 If you have insurance coverage in 
           If you move outside our                                      addition to US Family Health Plan
           service area ......................................12        Home Delivery for maintenance 
           Disenrollment                                                medications
                                                                        How to use Home Delivery ...........25
                                                                        Urgent and one-time ......................27  
                                                                        prescriptions
                                                                        Brighton Marine pharmacy
                                                                        Family-planning prescriptions
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