TRICARE covers the North Atlantic Treaty Organization (NATO) foreign nations’ armed forces members who are stationed in the United States or are guests of the U.S. Government. They receive the same benefits as American ADSMs, including no out-of-pocket expenses for care directed by the military treatment facility (MTF). Eligible accompanying family members can receive outpatient services under TRICARE Standard or TRICARE Extra. A copy of the family member’s identification card will have a foreign identification number or an actual SSN and indicate on the reverse "Outpatient Services Only." NATO family members do not need MTF referrals prior to receiving outpatient services from network providers. NATO family members follow the same prior authorization requirements as TRICARE Standard and TRICARE Extra beneficiaries, and are responsible for TRICARE Standard deductibles and cost-shares.
To collect charges for services not covered by TRICARE, you must have the NATO beneficiary agree, in advance and in writing, to accept financial responsibility for any non-covered service. To download a copy of the Request for Non-Covered Services form, go to www.hnfs.com.
NATO claims for ADSMs and ADFMs should be filed electronically the same way other TRICARE claims are submitted. If claims are submitted by mail, submit to:
Health Net Federal Services, LLC
c/o PGBA, LLC/TRICARE
P.O. Box 870140
Surfside Beach, SC 29587-9740
TRICARE will not cover inpatient services for NATO beneficiaries. To be reimbursed for inpatient services, have the NATO beneficiary make the appropriate arrangements with the NATO national embassy or consulate in advance.NATO beneficiary eligibility is now maintained in the Defense Enrollment Eligibility Reporting System (DEERS). Claims submission procedures are the same as for U.S. ADFMs in the United States.