Military Health, Tricare programs - Military Times

Tricare Help: Do I need supplemental insurance?

Q. Insurance plans never pay as much as providers charge. Do I need a Tricare supplement?

A. Unless you have other health insurance or enroll in Tricare Prime, I suggest you consider buying a bona fide, specially written, Tricare supplement. But ultimately, this is a decision only you can make. The Tricare Web site can give you many of the materials you’ll need to decide:

• Go to www.tricare.mil/mybenefit/home/overview/Plans and study the payment methods for Tricare Standard, Prime and Extra and the way each of those plans operates. You can download a handbook for each plan.

• Next, click the “Tricare Regions” link and make a permanent record of contact information for your Regional Tricare Office. Call them to discuss questions you will have regarding the catastrophic cap, provider participation and difficulties you may have in finding a Tricare Standard provider who will participate in Tricare on all your claims. Ask whether Tricare Prime is available where you live.

• Contact each of the several national military associations for information about the Tricare supplements they sell. Read the fine print in the policies carefully because those details are what you will get for your money, regardless of any ads or sales pitches.

Q. I’m an international business consultant and spend six to eight months a year outside the country. I have Medicare and Tricare for Life but no other health insurance. Do you have any insurance advice for me?

A. By federal law, Medicare cannot help pay for medical care you receive outside the U.S. and its possessions; in those cases, your only health insurance will be Tricare Standard.

You will have to pay out-of-pocket the 25 percent Tricare cost share of the amount allowed on every claim for foreign medical care, plus the $150 annual Tricare deductible.

Ordinarily I would not suggest this, but as Tricare Standard will be your only health insurance for a significant time each year, you may want to consider buying a Tricare supplement. Research the plans carefully to ensure you get the maximum coverage available for all your out-of-pocket costs on Tricare claims for foreign medical care. The dollar’s loss of value against foreign currencies may make foreign care more expensive than it has been in the past.

Look for any restrictions for pre-existing conditions; note that some Tricare supplements have their own deductible requirement. Make sure the policy does not require primary payment by Medicare.

Most large military associations sell Tricare supplements.

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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.