Line of Duty Care - Health Net Federal Services

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If you are a member of the National Guard and Reserve, and become ill or are injured while on active duty, you may be entitled to care under the line of ... HNFS.comTRICAREWestBeneficiaryAuthorizationsLineofDutyCare PublicTools NetworkProviderDirectory Non-NetworkProviderDirectory Choosing/ChangingYourPCM MilitaryHospitalLocator CoveredBenefits CopaymentorCost-Share IsApprovalNeeded SecureTools Eligibility,PCM&Deductible ManageMyPayment PaymentHistory AuthorizationStatus ChangeanAuthorization ClaimStatus EOBSummary UpdateOtherHealthInsurance AnnualBenefitsSummaryReport NominateaBeneficiaryforCaseorDiseaseManagement PreventiveServicesHistory AskUsSecureEmail UploadaDocument SecureInbox MyAccount LineofDutyCare IfyouareamemberoftheNationalGuardandReserve,andbecome illorareinjuredwhileonactiveduty,youmaybeentitledtocareunderthelineofduty(LOD)provisionornoticeofeligibility(NOE)forCoastGuard. EligibilityforCare Lineofduty careisspecifictotheacquiredinjuryorillness,andasaresult,youwillnotshowasaneligibleTRICAREbeneficiaryintheDefenseEnrollmentEligibilityReportingSystem(DEERS).Lineofdutyeligibilityisaserviceresponsibilityandinitiatedthroughtheunitmedicalrepresentative,notHealthNetFederalServices,LLC(HNFS)orDEERS. ToshowauthorizationforLODcare,youmusthaveinhand,yourordersormustersheet,alsoknownasanattendanceroster,andadocumentissuedbyyourunitrepresentativeshowingyoucanreceivecarefortheinjuryorillnessspecifictoyourservice.Yourhealthcareproviderwillusethisdocumentationtoverifyyouareeligibleforcare.Iftherearequestionsorfurthereligibilityverificationisrequired,theprovidermaycalltheDefenseHealthAgency–GreatLakes(DHA-GL)at1-888-647-6676. Itisyoursandyourunitmedicalrepresentative’sresponsibilitytoensureLOD/NOEeligibilitydocumentsaresubmittedtoDHA-GLpriortoyourappointmentwithahealthcareprovider.ThesedocumentsarelocatedonTRICARE'swebsite: TRICARELODpage DHA-GLProcessGuides DHA-GLwebsite HealthCareCoverage Lineofduty coverageisseparatefromanyotherTRICAREcoverageineffect,suchas: TransitionalAssistanceManagementProgramorTransitionalCareforService-RelatedConditionsprogram TRICAREReserveSelect TheLOD/NOEdeterminationisestablishedbyservice-specificpolicyandusedtodocument,establish,manageandauthorizehealthcareforNationalGuardandReservemembersinjuredwhileonweekenddrilldutyorwhileontrainingorders. ObtainingApprovalforCare Reviewthestepsbelowtoobtainapprovalforcare:  InitialhealthcareforanLODinjuryorillnessiscoordinatedbyyourunitmedicalrepresentative.Themilitaryhospital/clinicoverseeingyourLODinjuryorillness,orDHA-GL,willsubmitarequesttoHNFSforreviewwhencaremustbereceivedoutsideofthemilitaryhospital/clinic.  HNFSwillreviewtherequestandapprovecareasappropriate.  Thereferralsubmittedbythemilitaryhospital/clinicisvalidfor180daysandDHA-GLisvalidfor365days.Ifcontinuedcareisnecessarybeyondtheinitialapproval: Withintheepisodeofcare(180/365):YourservicingprovidercansubmitarequesttoHNFSforreview.  Beyondtheepisodeofcare(180/365):Yourservicingprovidershouldprovideyouwithdocumentationthatexplainstheneedforcontinuedcare.Youwillthenneedtocoordinatethecontinuedcarewithyourunitmedicalrepresentative.Ifadditionalcaremustbereceivedfollowingtheexpirationoftheinitialreferral,yourunitmedicalrepresentativeorDHA-GLwillsubmittherequireddocumentationtoHNFSforprocessing,andanapprovalwillbeissued.  Emergencyandurgentcareiscoveredifyouhaveaseriousillnessorinjuryduringweekenddrilldutyorwhileontrainingorders.PriorauthorizationfromHNFSorDHA-GLisnotrequiredforemergencyorurgentcare.



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