Supplemental Health Care Program

SHCP provides coverage for services from civilian doctors. You may be eligible for care under SHCP when your duty assignment is within 50 miles of a military hospital or clinic.

Who's Eligible?

To be eligible, you need to fall in the following groups:

  • Active duty service members
  • National Guard and Reserve members on active duty
  • National Guard and Reserve members authorized for Line of Duty care
  • Beneficiaries on the Temporary Disability Retirement List can obtain required periodic physical examinations
  • Medically retired former members of the armed services enrolled in the Federal Recovery Coordination Program
  • Eligible foreign military personnel (for outpatient care only)
  • National Oceanic and Atmospheric Administration personnel; U.S. Public Health Service personnel; and Reserve Officer Training Core students, cadets, and midshipmen
  • Any non-TRICARE eligible person who receives approval from a military hospital or clinic to receive civilian services under SHCP
  • Those with Medicare are not eligible for SHCP except:
    • If they are inpatient at a military hospital or clinic, and while remaining inpatient at the military hospital or clinic, require civilian diagnostic services that cannot be performed at the military hospital or clinic.

What's Covered?

Who’s covered under SHCP?

  • SHCP covers any health care service if the military hospital or clinic refers the patient or the military Service Point-of-Contact authorizes the care.
  • For covered services, ADSMs do not pay cost-shares, copayments, or annual deductibles.
  • The SPOC also acts as a liaison between the ADSM and all members of the healthcare process; from the civilian healthcare professional to the claims processor.

What’s the Authorization Process?

Now that you know what’s covered, let’s look at the authorization process.

  • The civilian healthcare provider submits a request to us for review.
  • We review the request is reviewed for services NOT excluded by TRICARE against coverage guidelines.
  • We approve or deny requests based on those findings.
  • If you receive a denial letter for non-covered services, a waiver from DHA may be needed to move forward. Instructions for the waiver will be included in the denial letter.

Last Updated 12/2/2024