Tricare Help: Tricare can collect from third party - Getting out, military health issues - Navy Times

Tricare Help: Tricare can collect from third party

Answering your questions on Tricare.

Q. I am the spouse of an active-duty soldier. I got in a car accident in January and had minor neck injuries, and was treated at the military clinic on post. I was told that Tricare will send my auto insurance company the medical bills. Will Tricare send it the bills to even though I received treatment from a military clinic on post? If so, how does that work?

A. If you were a civilian, the civilian doctors or hospital would seek payment for the costs of your medical care from whatever other party was responsible. Usually that would be an insurance company — your insurance, that of the other driver, or both.

A federal law called the Medical Care Recovery Act requires the government to do the same when one of its beneficiaries requires medical care and a third party is responsible for payment. The government (the military hospital — or Tricare, if you got civilian care) will seek recovery of the costs of your care from the third party (usually an insurance company) in the same way.

Remember, although you pay nothing for care at a military hospital, the care is not free. Ultimately, it’s paid for by the taxpayers.

If your Tricare claim includes a code number indicating care for a traumatic injury of some kind, Tricare will require you to submit a Third Party Liability Form. That allows Tricare to determine whether a third party may be responsible for payment. Then, Tricare will collect the reasonable costs of your care from that party.

You will not be involved in Tricare’s collection activities. Your responsibility ends when you submit the form.

Q. My husband retired from the Air Force in 1995 and immediately started another career with great benefits. We didn’t enroll in Tricare Prime and have used Tricare as secondary insurance only sporadically. Now he’s losing a battle with cancer and will soon die. At that time, I’ll lose all health benefits. Since I’m only 60, I will not qualify for Medicare for several more years. How do I enroll in Tricare Prime?

A. As a widow, you will retain your eligibility for Tricare for the rest of your life unless you remarry. If you remarry, you will forever lose your eligibility under your present husband’s sponsorship, even if the second marriage ends by death or divorce.

From now until you become entitled to Medicare at age 65 — and become eligible for Tricare for Life — you can enroll in Tricare Standard or Tricare Prime. Tricare Prime, however, is usually only available within 40 to 50 miles of a military hospital.

Meanwhile, for official details about Tricare eligibility for widows, and for guidance about enrolling in Tricare Standard or Tricare Prime, call the Defense Eligibility Enrollment Reporting System (DEERS) support office at 800-538-9552, or visit Tricare’s website.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159, or click here to email us. In email, include the word “Tricare” in the subject line and do not attach files. Get Tricare advice anytime on our Tricare Help blog.