Using Other Health Insurance
If you have any health insurance other than TRICARE, it is called "other health insurance." This insurance can be through your employer or a private insurance program. By law, TRICARE pays after all other health insurance, except for:
- TRICARE supplements
- State Victims of Crime Compensation Programs
- Other Federal Government Programs identified by the Director, Defense Health Agency (i.e. Indian Health Service)
This means your other health insurance processes your claim first. Then, you or your doctor files your claim with TRICARE.
Are you on active duty?
- You can't use other health insurance.
- TRICARE is your only coverage.
Do you have Medicare?
- TRICARE pays last after Medicare and your other health insurance
- Visit the Medicare website to see which plan—Medicare or your other health insurance—pays first
Keep Your Information Up-to-Date
It’s important to keep your other health information up-to-date.
- Tell your TRICARE contractors and doctors when you have other health insurance.
- If TRICARE gets your claim before your other health insurance processes it, TRICARE will deny it.
- If TRICARE pays first and then discovers you had other health insurance, TRICARE will take back any payments made and may only reprocess your claim after your other health insurance processes your claim.
If you keep your doctor and your contractor informed of your other health insurance, they can coordinate your benefits and ensure that your claims are paid quickly. >>Download and submit your region's other health insurance form.
Coordination of Benefits
Make sure you follow the rules of your other health insurance.
- Follow your other plan's rules for getting care and filing claims—file claims with them first.
- If your other plan doesn't cover the entire cost, file a claim with TRICARE.
- If your other plan denies a claim for failure to follow their rules, such as getting care without authorization or using a non-network provider, TRICARE may also deny your claim.
Ending Other Health Insurance Coverage
- If you lose your other health insurance, TRICARE becomes your primary payer.
- If you have TRICARE for Life, TRICARE becomes the second payer.
- You must update your status with your doctor and contractor if you are no longer covered by other health insurance.
Medicare is not Other Health Insurance
Medicare is a federal entitlement. If you have Medicare:
- Medicare pays first
- Your other health insurance pays second
- TRICARE pays last
Do you have other health insurance with prescription drug coverage?
Your other plan pays first and TRICARE pays second at the pharmacy. >>Learn more