Tricare Help: How do I file when Tricare is my second payer? - Getting out, military health issues - Navy Times

Tricare Help: How do I file when Tricare is my second payer?

Answering your questions on Tricare.

Q. I have another insurance policy from my employer. I know that I must always file first with that plan, but I need instructions for filing with Tricare as second payer. Can you help?

To file with Tricare as second payer to other health insurance, you must do the following:

1. Complete an official Tricare Claim Form DD 2642.

2. Attach a copy of exactly the same itemized bills as were sent to the other plan.

3. Attach a copy of the other plan’s explanation of benefits showing details of how it processed each of the charges.

4. Send the package to the Tricare claims processor for the state where you live.

Go online to download claim forms and to find mailing addresses and phone numbers for submitting Tricare claims. Remember to keep copies of all documents in your personal files.

Q. I will soon get Tricare for Life, and I am confused about Medicare Part A and Part B. What is the difference, and how will I know which one to use?

Medicare Part A is called hospital insurance. Although it covers some other things, its primary coverage is for things furnished and billed by a hospital.

Examples are your room and board, special diets, general nursing services, use of the laboratory and its personnel, use of imaging services — i.e., X-ray — and personnel, and the like. It does not cover doctors’ bills, even if you receive their services in the hospital.

Medicare Part B is called medical insurance. Primarily, it covers the costs of the services of your doctors and other professional care providers who will send you bills apart from the bill you get from the hospital.

The hospital will file a claim for its services with Medicare Part A. Your doctors and other care providers will file claims for their services with Medicare Part B.

For more information, call Medicare and request a free Medicare Handbook. You can also download a free electronic copy at Medicare’s website. Go to “Resource Locator” and click on “Medicare & You 2011 Handbook.”

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