Frequently Asked Questions

I have TRICARE and Medicare. Can I see a doctor or supplier who doesn't provide services through Medicare?

Yes, but you'll pay more. If you sign a private contract with an opt-out doctor or supplier:

• Medicare won't pay for services you get from this doctor or supplier, even if Medicare covers the service;
• TRICARE processes the claim and only pays the amount it would have paid if Medicare processed the claim (20% of the TRICARE-allowable chargeThe maximum amount TRICARE pays for each procedure or service.  This is tied by law to Medicare's allowable charges.); and
• You’re responsible for the rest of the TRICARE-allowable charge.

To learn more, visit Does your provider accept Medicare as full payment page. To find a doctor or supplier who accepts Medicare, visit Medicare's Find a doctor/supplier page.

Note: In areas where there is limited access to medical care, TRICARE may waive the second-payer status and process the claim as the primary payer.