Tricare Supplement Insurance – An Overview of Tricare for Life and Tricare Prime

If your health care insurance coverage is within the Military Health Services of the U.S. Department of Defense, only a portion of your family’s medical expenses are covered. You may be looking for supplemental insurance coverage that picks up where your Tricare Insurance Program stops.

The Tricare Supplemental Insurance Program is sponsored by the Retired Associates for the Uniformed Services, and is underwritten by the Hartford Life Insurance Company. ASI, the administrator of the program, reportedly leads the pack when providing corporate TRICARE Supplemental coverage for retired military employees and their dependents. Beginning in 1974, ASI marketed the supplemental plan through military associations like the American Military Retirees Association, the Retired Association for the Uniformed Services and the Uniformed Services Benefit Association. Other groups were added to the list, such as the Pentagon Federal Credit Union. YOU CANNOT BE TURNED DOWN FOR COVERAGE under this supplemental insurance plan. The coverage is available nationwide.

Two supplemental insurance plans are available through the Tricare Supplemental Insurance Program: the Comprehensive Plan and the High Option II Plan. Both help cover expenses of doctor visits, emergency room, in-hospital and out-patient care, prescriptions and other services, as well as 100 percent of covered excess charges up to the customary standard level. There is a $150 per person or $300 family maximum plan deductible each fiscal year in the High Option plan. The Comprehensive Plan outpatient deductible is $75 per person and $150 per family.

If you are a TRICARE/CHAMPVA recipient, under age 65, entitled to retired, retainer or equivalent pay, you are eligible for coverage in the Tricare Supplemental Insurance Program. Individuals over age 65 who are not eligible for Medicare, may also apply with specific requirements. Dependents of Active Duty Members also have plan options. Eligible spouses and children under age 21 (age 23 if they are in college), eligible spouses and children of active-duty service members, Tricare-eligible widow(er)s and ex-spouses also may apply.

Coverage is renewable to age 65 as long as those covered by your plan remain eligible. Exclusions, limitations, and pre-existing conditions limitations apply. Covered services include:

Services covered by TRICARE

• 100 percent of TRICARE cost share
• 100 percent of TRICARE Standard/Extra
• 50 percent of the POS deductible
• 100 percent standard excess charges

You will want to read the lengthy list of exclusions, limitations and pre-existing conditions limitations. Coverage is effective the first day of the month after your enrollment and first premium remittance are received. However, if, on that day, you or any family member covered under the plan are hospitalized, the plan goes into effect the day after you are released from the hospital.