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Supplemental Insurance

Many military associations and private companies offer supplemental insurance policies. Unlike other health insurance, which pays first, supplemental insurance pays after TRICARE pays its portion of the bill. It reimburses you for out-of-pocket medical expenses paid to civilian providers.

Each supplemental insurance plan has its own rules. Carefully consider you and your family's health care needs before purchasing a supplemental insurance plan. In some cases, such as with TRICARE Prime, the cost of the supplemental plan may exceed your out-of-pocket expenses.

The following are some questions you should answer before purchasing a supplemental insurance plan.

  1. What type of health care services does it cover? Will the plan cover costs beyond what TRICARE allows?
  2. Do they pay for services not covered by TRICARE or limit the conditions they do cover?
  3. How much is the supplement premium? How often is it paid?
  4. Are there different premium rates based on military status or age?
  5. Can premium payments be increased? Under what conditions?
  6. Is there a deductible to pay before the supplement pays?
  7. Is there a maximum limit on benefits (lifetime, annual, etc.)?
  8. Is there a pre-existing condition clause? If so, how long is the waiting period?
  9. Are there treatments that must be pre-approved before care is received?
  10. Does the supplement cover enrollment fees or copayments?
  11. Will it pay my cost share under the TRICARE Diagnostic Related Group system?
  12. Does the TRICARE supplement convert to a Medicare supplement? If so, how long before it can convert?
  13. Does it cover inpatient, outpatient, long term or overseas care?
  14. Does it have membership fees, annual or lifetime?
  15. Will it continue to cover care upon retirement from active duty?
  16. Will it continue to provide coverage for surviving TRICARE-eligible spouses and family members?
  17. How do I file a claim?  Is there a time limit?
  18. Does the plan have higher rates for smokers?
  19. Does the plan cover college students who live in a different part of the country?
  20. What happens if I move? Does the plan move with me?


Last Updated 10/28/2015