Tricare Help: Will I need a supplemental policy? - Getting out, military health issues - Navy Times

Tricare Help: Will I need a supplemental policy?

Q. When I get Medicare and Tricare for Life, do I need to buy a supplemental policy as well?

A. Under Tricare for Life, you will have the combined coverage of two full-coverage, stand-alone health care “insurance” policies. Medicare is the primary coverage, and Tricare Standard automatically is second payer to Medicare.

On the majority of Medicare claims, Tricare pays whatever Medicare doesn’t for every service that is also covered by Tricare. Tricare essentially acts as a free Medicare supplement, and its payment, combined with Medicare’s, pays the Medicare claim and provider’s bill in full. Tricare cost shares and deductibles are waived on those claims.

Occasionally, you may have a Medicare claim on which Medicare does not cover all the services you received, and only Tricare will be able to pay anything for one or more items.

All Tricare claims processing rules, including the deductible and cost share, will apply to these “Tricare-only” claims. They will be the only claims on which a Tricare supplement would be of any benefit.

But such claims are unpredictable. You might go a year without such a claim, or you could have several in a row.

I have never heard of a supplement that covers both Medicare and Tricare. It would take two such policies to provide complete coverage, and that would be expensive.

Only you can weigh the potential need for, or benefit from, a Tricare supplement when compared with its premiums, based on your particular situation and medical needs.

Q. What will happen to my wife’s Tricare coverage if I die?

A. Your death would have no effect on your wife’s Tricare eligibility — as long as she does not remarry. If she remains single, her Tricare eligibility, including Tricare for Life, would continue for as long as she lives.

However, if she remarried, she would immediately lose her Tricare eligibility under your sponsorship. And even if her second marriage ended by death or divorce, her Tricare eligibility under your sponsorship could never be restored.

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Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In e-mail, include the word “Tricare” in the subject line and do not attach files. Get more Tricare advice at our Tricare blog, www.militarytimes.com/tricarehelp.