Tricare Help: Husband is not the father; is baby covered? - Getting out, military health issues - Navy Times

Tricare Help: Husband is not the father; is baby covered?

Answering your questions on Tricare.

Q. My husband is on active duty, but we have been separated for two years. I have a boyfriend, and I am pregnant with his baby. Will Tricare pay for my maternity care? Will my baby have Tricare coverage even if my husband is not the father?

A. I’m not a lawyer, and you and your husband need to consult with one about this matter. If you can’t afford one, call your Legal Aid Society or a lawyer referral service. Your husband can get free legal help by contacting the Office of the Judge Advocate General at his military facility.

It’s possible you and your baby are covered by Tricare for as long as you are legally married to your active-duty sponsor. To be certain of coverage in your situation, call the Defense Enrollment Eligibility Reporting Service support office, toll free, at 800-538-9552 for official information about your and your baby’s Tricare eligibility. Please note that DEERS does not provide legal advice or assistance.

Q. I will get Medicare and Tricare for Life in July. Will I need a Medicare supplement?

A. That is a decision only you can make — although most Tricare for Life beneficiaries find they do not need a Medicare supplement. Here is some information to help you decide:

Under TFL, you will have two full-coverage, stand-alone health care policies, Medicare and Tricare, with Tricare Standard automatically becoming second payer to Medicare. It acts as a free Medicare supplement.

Under TFL, you must get all your medical care from Medicare providers who will file a Medicare claim for those services. Medicare will process the claim, pay its share to the provider, and automatically forward the claim to Tricare. For every medical service that is covered by Medicare and Tricare — the vast majority of your claims — Tricare will pay what Medicare did not, and the bill will be paid in full.

Other Medicare supplements are written so that if Medicare does not pay for a given service, neither will the supplement. You would have to pay the full amount for any service that Medicare does not cover.

Not so with TFL. If Medicare does not pay for a service that is covered by Tricare, Tricare will act as your only health insurance and pay whatever it would have paid before you got TFL. It must apply the Tricare deductible and cost share, but after that, it will pay whatever is left unpaid on the amount allowed. Ë

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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 Tricare advice anytime on the Tricare Help blog.