Many military associations and private companies offer supplemental insurance policies. Unlike other health insuranceHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "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.
- What type of health care services does it cover? Will the plan cover costs beyond what TRICARE allows?
- Do they pay for services not covered by TRICARE or limit the conditions they do cover?
- How much is the supplement premium? How often is it paid?
- Are there different premium rates based on military status or age?
- Can premium payments be increased? Under what conditions?
- Is there a deductible to pay before the supplement pays?
- Is there a maximum limit on benefits (lifetime, annual, etc.)?
- Is there a pre-existing condition clause? If so, how long is the waiting period?
- Are there treatments that must be pre-approved before care is received?
- Does the supplement cover enrollment fees or copayments?
- Will it pay my cost share under the TRICARE Diagnostic Related Group system?
- Does the TRICARE supplement convert to a Medicare supplement? If so, how long before it can convert?
- Does it cover inpatient, outpatient, long term or overseas care?
- Does it have membership fees, annual or lifetime?
- Will it continue to cover care upon retirement from active duty?
- Will it continue to provide coverage for surviving TRICARE-eligible spouses and family members?
- How do I file a claim? Is there a time limit?
- Does the plan have higher rates for smokers?
- Does the plan cover college students who live in a different part of the country?
- What happens if I move? Does the plan move with me?