Using TRICARE For Life at Veterans Affairs Facilities
Veterans Affairs (VA) facilities aren't Medicare-authorized providers, even if they're in the TRICARE network.
Medicare can't pay for care at a government facility.
- If you use TRICARE For Life for a non-service-connected condition at a VA facility, the VA can't bill Medicare.
- When you get care from a non-Medicare provider (such as the VA) TRICARE can pay only up to 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..
- You will have to pay the remaining amount after TRICARE pays its 20% of the TRICARE allowable charge.
TRICARE and the VA recommend that you get care for your service-connected disability at a VA facility. For all of your other care, consider all of your options, including using a Medicare-certified provider. When using Medicare providers, you typically have no out-of-pocket costs for services covered by both Medicare and TRICARE.
Talk to your VA facility about your VA options, including how VA claims are processed if you are entitled to Medicare or have 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.".
Want to order a hard copy of the TRICARE For Life Handbook? Call Wisconsin Physicians Service (WPS) at 1-866-773-0404.
Last Updated 12/17/2015