Using Other Health Insurance
If you have any health insurance other than TRICARE, it is called "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."." It can be through your employer or a private insurance program. By law, TRICARE pays after all other health insurance, except for:
- TRICARE supplements
- State Victims of Crime Compensation Programs
- Other Federal Government Programs identified by the Director, Defense Health Agency (i.e. Indian Health Service)
This means your other health insurance processes your claim first. Then, you or your doctor files your claim with TRICARE.
Are you an active duty service member? If so and you use OHI, you are responsible for all costs associated with that care. You should contact your service personnel representative for more information.
Do you have Medicare?
- Medicare is a federal entitlement
- TRICARE pays last after Medicare and your other health insurance
- Visit the Medicare website to see which plan—Medicare or your other health insurance—pays first
Keep Your Information Updated
It’s important to keep your other health information updated
- Tell your TRICARE contractors and doctors when you have other health insurance.
- If TRICARE gets your claim before your other health insurance processes it, TRICARE will deny it.
- If TRICARE pays first and then discovers you had other health insurance, TRICARE will take back any payments made. They will only reprocess your claim after your other health insurance does.
Keep your doctor and your contractor updated on your other health insurance. They can coordinate your benefits and ensure your claims are paid quickly. >>Download and submit your region's other health insurance form.
Coordination of Benefits
- Follow the rules of your other health insurance for getting care and filing claims.
- If your other plan doesn't cover the entire cost, file a claim with TRICARE.
- If your other plan denies a claim for failure to follow their rules, TRICARE may also deny your claim.
Do you have other health insurance with prescription drug coverage? Your other plan pays first and TRICARE pays second at the pharmacy.
Ending Other Health Insurance Coverage
- If you lose your other health insurance, TRICARE becomes your primary payer.
- If you have TRICARE for Life, TRICARE becomes the second payer.
- You must inform your doctor and contractor by completing and returning this form.
- Failure to tell your doctor or contractor may result in TRICARE denying your claims.
Last Updated 3/16/2023