TRICARE Supplemental Insurance for Military Retirees

Retired service members of the uniformed services and their family members (spouses and children) are eligible for TRICARE.  The uniformed services include the:

U.S. Army
U.S. Air Force
U.S. Navy
U.S. Marine Corps
U.S. Coast Guard

Retired service members and their family members are eligible for the following options:

  • TRICARE Prime (enrollment fees apply)

  • TRICARE Standard and Extra

  • US Family Health Plan (in specific U.S. locations)

  • TRICARE For Life (with Medicare Part A & B coverage)

  • TRICARE Standard Overseas

  • TRICARE Retiree Dental Program

Tricare StandardMilitary Retirees (retiring from Active Duty) and their families have another option for their health care – TRICARE Supplemental Insurance.  Several different private medical insurance companies offer supplemental insurance coverage that will pick up the remaining 20% of your health care costs that TRICARE Standard does not cover.  What does that mean to you?  For a trip to the doctor TRICARE Standard would cover 80% of that doctor’s fees and your supplemental insurance would pick up the remaining 20% – that covers all of your expenses.  The only out of pocket expenses are your deductibles each fiscal year (starting October 1st each year).  The deductible is $150 per person or $300 per family.  Once you reach those deductibles, you will incur no further costs and your supplemental insurance covers the rest.

By law, TRICARE pays claims only after all other health insurances pay. Your coordination of benefits between other health insurance and TRICARE varies depending on who you are or which plan you are using. For the most accurate information, please enter your profile now.

TRICARE Prime versus Standard for Retirees

Upon retirement, you get to choose whether you wish to say on as TRICARE Prime, or if you wish to move to TRICARE Standard.  If you decide not to enroll in TRICARE Prime when you retire, you and your family are automatically covered by TRICARE Standard and Extra.  Enrollment is not required for either option and you may seek care from any TRICARE authorized provider. When using TRICARE Standard and Extra, you manage your own health care. There are no special rules
accessing certain types of care. You’ll never require referrals, but some services may require prior authorization.

It’s also important for you to understand the type of provider you are seeing. You can visit any TRICARE authorized provider—network or
non network—but the type of provider you see determines your out of pocket costs. When you visit a non network provider, you’re using the
TRICARE Standard option, and when you visit a network provider, you’re using the TRICARE Extra option. Your cost shares are five percent
lower with TRICARE Extra and network providers will file claims on your behalf.

Your status change must be reflected in the Defense Enrollment Eligibility Reporting System (DEERS) in order for TRICARE to process the application. TRICARE will continue to check DEERS for your change of status up until the 10th day of the month in which your stated status change is effective. Once the sponsor’s status change is confirmed through DEERS, we will process the application.

If your status has not been updated by the 10th of the month as described above, your application will be returned to you.

TRICARE For Life

If using TRICARE For Life in the U.S. or a U.S. Territory, Medicare processes the claim and automatically forwards it to your other health insurance. Once your other health insurance processes the claim, you must file a paper claim with the TFL contractor. The contractor will process the claim and pay TRICARE’s portion of the claim directly to you.

If using TRICARE For Life overseas, you’ll need to follow your other health insurance plan’s rules getting care and file claims with them first.

TRICARE Standard with Supplemental Insurance
—what this means to you and your family:

  • Your family has the freedom of choice to choose any doctor (as long as that doctor accepts TRICARE)
  • No need to first see a “Primary Care Provider” – your family makes appointments with the doctor or specialist directly
  • No need to try to make an appointment at the closest “Military Treatment Facility” – in fact, families on TRICARE Standard are encouraged to seek local doctors instead
  • Spouses and children can seek after-hours care immediately, without a lengthy referral process
  • With Supplemental Insurance, you only pay either the individual deductable ($150 per fiscal year) or the family deductable ($300 per fiscal year), whichever occurs first.

 

Be Sociable, Share!


Related Posts:

  1. TRICARE Insurance

Comments

  1. Joellyn Godfrey says:

    I have recently discovered that Tricare Prime Beneficiaries, spouses of military retirees will no longer be eligible for Tricare Prime, effective October 1, 2013. Some of the Prime Beneficiaries are not able to pay the 20 or 25 percent of the fees we will be required to pay. Not all of the supplemental health plans will pay for the remainder of the services that we will be forced to pay. Is there any alternatives available to us, especially for those that do not live near a military treatment facility, also not all MTF’s will see retirees.

Speak Your Mind

*