Tricare Help: Not all supplements work with Tricare - Military Health, military health and wellness, military physical fitness - Military Times

Tricare Help: Not all supplements work with Tricare

Answering your questions on Tricare.

My wife and I have Tricare for Life. We’re going to take a cruise, and we know that Tricare Standard will be our only coverage as soon as we leave U.S. waters, since the Medicare portion of Tricare for Life can’t be used. We need a short-term Tricare supplement that will pay our Tricare Standard deductible and cost shares. Do you know of any? The cruise company offers a health insurance policy, but it won’t work with Tricare.

I know of no reliable U.S. insurer that sells a genuine, short-term Tricare supplement.

A genuine Tricare supplement states in its fine print that it is written specifically to be a Tricare supplement. It covers only what Tricare covers, and it pays only after Tricare pays. Regardless of whatever else the policy provides, that description and purpose are required by federal law.

Short-term policies offered by cruise agents are inadvisable for Tricare beneficiaries because, on analysis of their fine print, all are required to be second payer to the customer’s other health insurance. But federal law does not allow Tricare to pay first, with only two exceptions: when it is used with a genuine Tricare supplement, or with welfare-related plans such as Medicaid. If the short-term policy doesn’t pay first, Tricare can’t pay anything.

Without a short-term Tricare supplement, it appears that your only protection from Tricare’s deductible and cost shares may be to buy a regular Tricare supplement, or to rely on your $3,000 catastrophic cap to limit your out-of-pocket liability.

If you opt for a regular Tricare supplement, read the fine print carefully before you buy. Some have deductibles, restrictions on pre-existing conditions or other limitations. Thus, they may provide less protection than you need for the short term.

I have a health insurance policy at work, but its prescription plan’s co-payment is much higher than Tricare’s. Is there any way we can use Tricare for our prescriptions instead of my company insurance?

Unfortunately, no. Federal law requires Tricare always to be last payer. That means if you have other health insurance with a pharmacy benefit, you must use it first. However, you can file claims with Tricare for reimbursement of a portion of your other plan’s co-payment.

With some commercial plans, the pharmacy benefit is optional. Contact your other health insurance to determine whether that’s the case with your policy. If you can drop the other plan’s pharmacy benefit, you can use the Tricare Pharmacy Program as first payer for your prescription services.