Tricare And Private Insurance: Can You Have Both?

It is not illegal to have private insurance and also be covered by Tricare. In fact, it is quite common for people to have multiple types of health insurance, and in this case, any health insurance other than Tricare is referred to as other health insurance (OHI). However, it is important to understand how having multiple insurance policies can impact the claims and billing process. By law, Tricare pays after all other health insurance has paid out, with some exceptions for other federal insurance programs.

Tricare is considered secondary coverage

It is not illegal to carry private insurance and also be covered by Tricare. In fact, it is quite common for people to have multiple types of health insurance, and in this case, Tricare is considered secondary coverage. This means that your private insurance is your primary coverage and will pay your medical claims first. After your doctor, hospital, or pharmacy has been paid by your private insurance, they will then file a claim with Tricare or send you a bill for any remaining costs. If you receive the bill, you should forward it to Tricare.

It is important to note that Tricare will only pay after all other health insurance has paid, with the exception of certain other federal government programs, such as Medicare, Medicaid, VA healthcare, or Indian Health Service coverage. In the case of these programs, Tricare will pay first if you are treated for a non-covered condition.

Additionally, if you have Tricare and are eligible for Medicaid, Tricare will pay first, and Medicaid will cover any remaining costs. This is because, by law, Medicaid is the "payer of last resort", meaning it usually only pays when a person has no other health insurance.

To ensure that your claims are processed smoothly, it is important to keep your Tricare contractors and doctors informed about any other health insurance you have. If Tricare pays a claim before discovering that you have other health insurance, they will take back any payments made and will only reprocess the claim after your other insurance has paid.

Other health insurance is processed first

It is not illegal to carry private insurance plus Tricare. In fact, it is encouraged that you inform your doctor and contractor about all your insurance plans. This is because, if you have any health insurance other than Tricare, that insurance is considered the "primary coverage" and will be billed before Tricare.

Tricare is considered "secondary coverage" and will only pay your medical claims after your other health insurance has processed them first. This means that your other health insurance program will pay your doctor, hospital, or pharmacy first, and then they will file a claim with Tricare or send you a bill for any remaining costs. If you receive the bill, you should then send it to Tricare.

The only exception to this rule is if you have other federal insurance, such as Medicare, Medicaid, VA healthcare, or Indian Health Service coverage. In this case, your federal insurance will pay first, and Tricare will pay for any non-covered conditions. Additionally, if you are eligible for Medicaid, Tricare will pay first, and Medicaid will cover any remaining costs.

It is important to keep your other health information updated and inform your Tricare contractors and doctors when you gain or lose other health insurance. If Tricare processes your claim before your other health insurance, they will deny it. Similarly, if Tricare pays first and then discovers you have other health insurance, they will take back any payments made and will only reprocess your claim after your other insurance has paid.

Inform doctors of other insurance

It is not illegal to carry private insurance plus Tricare, and many people have multiple health insurance plans. However, it is important to inform your doctors and other medical providers when you have multiple insurance coverages. This is because, when there is more than one payer, "coordination of benefits" rules decide which insurance pays first. The "primary payer" pays what it owes on your bills first, and then sends the rest to the "secondary payer" to pay. The secondary payer only pays if there are costs the primary insurer didn't cover.

If you have Tricare and another insurance plan, the other insurance will almost always be billed before Tricare. Your other insurance is your primary coverage and pays your medical claims before Tricare. Tricare is considered secondary coverage. After your doctor, hospital, or pharmacy is paid by your other insurance, they will file a claim with Tricare or send you a bill for any remaining costs. If you receive the bill, you should send it to Tricare.

The only exception to this rule is if you have other federal insurance, such as Medicare, Medicaid, VA healthcare, or Indian Health Service coverage. If you are covered by one of these plans, they pay before Tricare. If you are treated for a non-covered condition, Tricare pays first.

It is important to keep your doctors and contractors updated on your other insurance coverage. They can coordinate your benefits and ensure your claims are paid quickly. If Tricare gets your claim before your other insurance processes it, Tricare will deny it. If your other plan doesn’t cover a particular service and you think Tricare might cover it, file a claim with Tricare. If Tricare pays first and then discovers you had other insurance, Tricare will take back any payments made and will only reprocess your claim after your other insurance pays.

TRICARE denies claims if processed first

It is not illegal to carry private insurance and TRICARE concurrently. However, TRICARE is considered secondary coverage, meaning that your other insurance is your primary coverage and will pay your medical claims before TRICARE. If TRICARE receives your claim before your other health insurance processes it, TRICARE will deny the claim.

If your other health insurance denies a claim for failure to follow their rules, TRICARE may also deny your claim. For example, if your other insurance denies your claim because their authorization requirements were not followed, or you used a provider outside of their network, TRICARE may also deny the claim. In this case, you would be responsible for paying your providers, hospitals, suppliers, and pharmacies the full amount of their billed charges.

If your other plan does not cover the entire cost, you can file a claim with TRICARE. If your other plan does not cover a particular service at all, and you think TRICARE might cover it, you can file a claim with TRICARE. TRICARE will reimburse you for TRICARE-covered services at the TRICARE allowable amount. This amount will not include any copayments, cost-shares, or deductibles.

If your claim is denied, you can contact your claims processor for help. If you believe your claim was inappropriately denied, you or another appropriate party may file an appeal.

TRICARE becomes primary payer if other insurance is lost

It is not illegal to carry private insurance and TRICARE simultaneously. In fact, TRICARE is designed to work alongside other health insurance. Any health insurance other than TRICARE is classed as "other health insurance". This can be provided by an employer or a private insurance programme.

TRICARE becomes the primary payer if you lose your other health insurance. If you have TRICARE for Life, TRICARE becomes the second payer after Medicare. You must inform your doctor and contractor by completing and returning a form. Failure to do so may result in TRICARE denying your claims. You have 90 days after losing or gaining other health insurance to change your TRICARE health plan.

If you have other health insurance, it will almost always be billed before TRICARE. Your other health insurance is your primary coverage and pays your medical claims before TRICARE. TRICARE is considered secondary coverage. After your doctor, hospital, or pharmacy has been paid by your other health insurance, they will file a claim with TRICARE or send you a bill for any remaining costs. If you receive the bill, you should send it to TRICARE.

The only exception to this rule is if you have other federal insurance, such as Medicare, Medicaid, VA healthcare, or Indian Health Service coverage. If you are covered by one of these plans, they pay before TRICARE. If you are treated for a non-covered condition, TRICARE pays first.

Frequently asked questions