How TRICARE Works with Other Health Insurance
TRICARE pays claims only after all other health insurance plans pay.
- Follow your other health insurance plan's rules for getting care and file claims with them first.
- If there is an amount your other health insurance does not cover, you can file the claim with TRICARE for reimbursement.
- If your other health insurance 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.
TRICARE For Life
If you use TRICARE For Life in the U.S. or a U.S. Territory, TRICARE is the third payer.
- Medicare processes the claim and forwards it to your other health insurance.
- After your other health insurance processes the claim, you'll need to file a paper claim with the TRICARE For Life contractor, Wisconsin Physicians Service (WPS-TFL)
- WPS-TFL processes the claim and pays TRICARE's portion of the claim directly to you.
If you use TRICARE For Life overseas, follow your other health insurance plan's rules getting care and file claims with them first. If there is an amount your other health insurance does not cover, you can file the claim with the overseas claims processor for reimbursement.
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