Line of Duty Care
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 duty (LOD) provision or notice of eligibility (NOE) for Coast Guard.
Eligibility for Care
Line of duty care is specific to the acquired injury or illness, and as a result, you will not show as an eligible TRICARE beneficiary in the Defense Enrollment Eligibility Reporting System (DEERS). Line of duty eligibility is a service responsibility and initiated through the unit medical representative, not Health Net Federal Services, LLC (HNFS) or DEERS.
To show authorization for LOD care, you must have in hand, your orders or muster sheet, also known as an attendance roster, and a document issued by your unit representative showing you can receive care for the injury or illness specific to your service. Your health care provider will use this documentation to verify you are eligible for care. If there are questions or further eligibility verification is required, the provider may call the Defense Health Agency – Great Lakes (DHA-GL) at 1-888-647-6676.
It is yours and your unit medical representative’s responsibility to ensure LOD/NOE eligibility documents are submitted to DHA-GL prior to your appointment with a health care provider. These documents are located on TRICARE's website:
Health Care Coverage
Line of duty coverage is separate from any other TRICARE coverage in effect, such as:
- Transitional Assistance Management Program or Transitional Care for Service-Related Conditions program
- TRICARE Reserve Select
The LOD/NOE determination is established by service-specific policy and used to document, establish, manage and authorize health care for National Guard and Reserve members injured while on weekend drill duty or while on training orders.
Obtaining Approval for Care
Review the steps below to obtain approval for care:
- Initial health care for an LOD injury or illness is coordinated by your unit medical representative. The military hospital/clinic overseeing your LOD injury or illness, or DHA-GL, will submit a request to HNFS for review when care must be received outside of the military hospital/clinic.
- HNFS will review the request and approve care as appropriate.
- The referral submitted by the military hospital/clinic is valid for 180 days and DHA-GL is valid for 365 days. If continued care is necessary beyond the initial approval:
- Within the episode of care (180/365): Your servicing provider can submit a request to HNFS for review.
- Beyond the episode of care (180/365): Your servicing provider should provide you with documentation that explains the need for continued care. You will then need to coordinate the continued care with your unit medical representative. If additional care must be received following the expiration of the initial referral, your unit medical representative or DHA-GL will submit the required documentation to HNFS for processing, and an approval will be issued.
Emergency and urgent care is covered if you have a serious illness or injury during weekend drill duty or while on training orders. Prior authorization from HNFS or DHA-GL is not required for emergency or urgent care.