Tricare For Life: A Smart Supplemental Insurance Choice?

TRICARE For Life is a supplemental insurance plan that covers individuals who are TRICARE-eligible and have Medicare Part A and B. It is available worldwide and provides peace of mind by helping to protect individuals from out-of-pocket medical and pharmacy costs, including co-insurance, doctor bills, hospital charges, and catastrophic expenses. While TRICARE is a comprehensive health plan, it may leave beneficiaries with medical and pharmacy costs that can add up. The TRICARE Supplement Insurance wraps around TRICARE coverage, offering 100% reimbursement for covered services, including medical and pharmacy costs. This insurance plan is designed to help individuals manage their healthcare expenses effectively.

TRICARE For Life is Medicare-wraparound coverage

TRICARE For Life (TFL) is Medicare-wraparound coverage for those who are TRICARE-eligible and have Medicare Part A and B, regardless of age or place of residence. Coverage is only for those with Medicare and who are TRICARE-eligible; it does not extend to family members. TFL coverage is automatic for those with Medicare Part A and B, and coverage starts the first day that Medicare Part A and B are in effect.

TFL does not require an enrollment card. Instead, you need your Medicare card and military ID as proof of coverage. You may visit any authorized provider. In most cases, your provider files your claims with Medicare, which pays its portion first and then sends the claim to the TRICARE For Life claims processor. TRICARE For Life then pays the provider directly for TRICARE-covered services.

Generally, you will have no out-of-pocket costs for services that both Medicare and TRICARE cover. However, you will have out-of-pocket costs for care that isn't covered by Medicare and/or TRICARE. You can get care at military hospitals and clinics, but only if space is available.

Medicare provides coverage in the U.S. and U.S. Territories, but not in other overseas locations. When using TRICARE For Life overseas, TRICARE is the primary payer, and you are responsible for paying TRICARE's annual deductible and cost shares. If you live overseas, you must have Medicare Part B to remain eligible for TRICARE, even though Medicare doesn't provide coverage outside of the U.S. and its territories.

You don't pay any enrollment fees for TFL, but you must pay Medicare Part A and Medicare Part B monthly premiums. Medicare Part A is paid from payroll taxes while you are working, and your Part B premium is based on your income.

If you have other health insurance, such as a Medicare supplement or an employer-sponsored health plan, you can still use TRICARE For Life as long as you have both Medicare Parts A and B. If you have employer-sponsored insurance with your current employer, your other health insurance pays first, followed by Medicare. In this case, your employer will file your health claims. If you have other health insurance that isn't based on your or a family member's current employment, Medicare pays first, followed by the other health insurance. In this case, you must file a claim with the TFL contractor by submitting a paper claim to WPS along with a copy of your provider's itemized bill, the Medicare Summary Notice, and the explanation of benefits from all other health insurances. Your claim must be filed within one year from the date of care.

It's available to those with Medicare and who are TRICARE-eligible

TRICARE For Life (TFL) is a supplemental insurance plan that is available to individuals who are both Medicare-eligible and TRICARE-eligible. This means that to qualify for TFL, you must have Medicare Part A and B, regardless of your age or place of residence. It is important to note that TFL is not available to family members, and coverage is only for the individual who meets the eligibility criteria.

TFL provides Medicare-wraparound coverage, which means it supplements your Medicare coverage. With TFL, you can visit any authorized provider, including military hospitals and clinics, although space may be limited in these facilities. TFL is also available worldwide, including in the US, US Territories, and overseas locations. However, it's important to note that Medicare does not provide coverage in overseas locations outside of the US and its territories, so if you live or travel overseas, TRICARE becomes the primary payer, and you are responsible for paying TRICARE's annual deductible and cost shares.

One of the benefits of TFL is that there is no separate enrollment process or card. Your Medicare card and military ID serve as proof of coverage. When you receive medical services, your provider will first file claims with Medicare, which pays its portion. Afterward, the claim is sent to the TFL claims processor, and TFL pays the provider directly for TRICARE-covered services. This means that you generally won't have any out-of-pocket costs for services covered by both Medicare and TRICARE. However, you will have out-of-pocket expenses for care that isn't covered by either Medicare or TRICARE.

In addition to TFL, there are also TRICARE Supplement Insurance Plans offered by private companies and military associations. These plans can help pay for out-of-pocket costs associated with TRICARE, such as co-insurance, doctor bills, hospital charges, and pharmacy costs. They provide reimbursement for costs incurred at civilian providers. It's important to carefully review the details of these supplemental plans, as they have varying rules, eligibility requirements, and coverage limits.

It can be used alongside other health insurance

TRICARE For Life (TFL) is a supplemental insurance plan that can be used alongside other health insurance such as Medicare or an employer-sponsored health plan. It is important to note that TRICARE supplements themselves do not qualify as "other insurance". TFL is available to those who are TRICARE-eligible and have Medicare Parts A and B, regardless of age or place of residence. Coverage is not extended to family members.

If you have other health insurance in addition to TFL, the order in which the insurance plans pay for your healthcare costs depends on the type of other insurance you have. If you have employer-sponsored insurance with your current employer, then the other health insurance pays first, Medicare pays second, and TFL pays last. In this case, your employer will file your health claims. If you have other health insurance that is not based on your or a family member's current employment, then Medicare pays first, the other insurance pays second, and TFL pays last. In this case, you must file a claim with the TFL contractor, Wisconsin Physicians Service (WPS).

To file a claim with WPS, you will need to submit a paper claim along with the following documentation:

• Your provider's itemized bill
• The Medicare Summary Notice
• The explanation of benefits from all other health insurances

Your claim must be filed within one year of the date of care.

Supplemental insurance plans can provide peace of mind and protect you from out-of-pocket medical expenses, co-insurance, doctor bills, hospital and pharmacy costs, and catastrophic expenses. Each supplemental insurance plan has its own rules, so it is important to carefully consider your own and your family's healthcare needs before purchasing a plan.

It covers 100% of doctors' visits, pharmacy, and hospital co-pays

TRICARE For Life (TFL) is a Medicare-wraparound coverage plan for those who are TRICARE-eligible and have Medicare Part A and B. It is available worldwide and does not require any enrollment fees. TFL is a good option for supplemental insurance as it covers 100% of doctors' visits, pharmacy, and hospital co-pays. This means that individuals with TFL will not have any out-of-pocket costs for these services.

The TRICARE Supplement Insurance Plan is designed to fill the gaps left by TRICARE, ensuring that individuals don't have to worry about unexpected medical expenses. In most cases, individuals with TRICARE Supplement Insurance will receive 100% reimbursement for TRICARE-covered services, including medical and pharmacy costs. This means that if an individual visits a doctor, TRICARE Select will cover 75% of the provider's fee, while the TRICARE supplemental insurance will cover the remaining 25%.

It is important to note that TRICARE Supplement Insurance is different from TRICARE supplements, which are offered by military associations and private companies. These supplemental plans pay after TRICARE and reimburse individuals for out-of-pocket medical expenses paid to civilian providers. When considering a supplemental insurance plan, it is crucial to carefully review the plan's coverage, limitations, and costs to ensure it meets your specific needs.

For those with TRICARE For Life, the process is slightly different. Medicare pays its portion first, and then the claim is sent to the TRICARE For Life claims processor. TRICARE For Life then pays the provider directly for TRICARE-covered services, resulting in no out-of-pocket costs for the individual. This makes TRICARE For Life a valuable option for supplemental insurance, especially when combined with the peace of mind that comes with knowing you are protected from unexpected medical expenses.

It's available worldwide

TRICARE For Life (TFL) is a Medicare wraparound coverage plan that is available worldwide. This means that TFL is available to eligible beneficiaries regardless of their place of residence.

Medicare, however, only provides coverage in the U.S. and its territories. This includes American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands. Therefore, if you are using TFL overseas, TRICARE becomes the primary payer. You will be responsible for paying TRICARE's annual deductible and cost shares.

If you live overseas, you must have Medicare Part B to remain eligible for TRICARE, even though Medicare does not provide coverage outside the U.S. and its territories.

With TFL, you can generally seek care from any overseas civilian provider without a referral. However, certain services, such as non-emergency inpatient admissions for substance use disorders and mental health care, require prior authorization.

It is important to note that outside the U.S. and its territories, non-participating non-network providers can charge any amount for care. You will be responsible for paying any amount that exceeds the TRICARE-allowable charge, in addition to your deductible and cost shares.

TFL is a good option for supplemental insurance if you are a TRICARE beneficiary with Medicare Part A and Part B, as it provides worldwide coverage. However, it is always a good idea to carefully consider your own healthcare needs and review the details of any insurance plan before making a decision.

Frequently asked questions