Is TRICARE always secondary?

Asked by: Imogene Wolff II  |  Last update: February 9, 2022
Score: 4.3/5 (2 votes)

Ending Other Health Insurance Coverage
If you lose your other health insurance, TRICARE becomes your primary payer. If you have TRICARE for Life, TRICARE becomes the second payer.

Is TRICARE primary or secondary to employer insurance?

TRICARE is the secondary payer to all health benefits and insurance plans, except for Medicaid, TRICARE supplements, the Indian Health Service and other programs or plans as identified by the Defense Health Agency (DHA).

Is TRICARE primary or secondary to Medicare?

Medicare is your primary payer. TRICARE pays second to Medicare or last if you have other health insurance. ... When retired service members or eligible family members reach age 65 and are eligible for Medicare, they become eligible for TRICARE For Life and are no longer able to enroll in other TRICARE plans.

Is TRICARE always last payer?

By law, Tricare must be last payer to all other health insurance except in very narrow and specific circumstances that almost surely do not apply to you.

Is TRICARE Select Primary?

With TRICARE Select, you can choose your own TRICARE-authorized provider and manage your own health care. This means the plan is like a preferred-provider organization, or PPO plan. A primary care manager isn't assigned to you. ... In general, TRICARE Select enrollees have more choice of providers.

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Can TRICARE be secondary insurance?

If you lose your other health insurance, TRICARE becomes your primary payer. If you have TRICARE for Life, TRICARE becomes the second payer. You must inform your doctor and contractor by completing and returning this form.

Is TRICARE always secondary to commercial insurance?

TRICARE is the primary payer and coordination of benefits with other insurance carriers does not occur.

Is TRICARE a third party payer?

2 TRICARE is the DoD program for civilian health benefits for U.S. Armed Forces military personnel, military retirees, and their dependents. ... For children enrolled in Medicaid on a basis other than disability, TRICARE is the largest source of third- party public coverage.

Is TRICARE Dental primary or secondary?

As your secondary plan, TDP will never pay more than your dentist charges. TDP also will never pay more than it would have paid as the primary insurance plan.

Is TRICARE public or private insurance?

TRICARE is a government-sponsored health insurance program for active duty, Reserves, retired military members, and eligible family members.

Does TRICARE or Medicare pay first?

For active-duty military enrolled in Medicare, TRICARE pays first for Medicare- covered services or items, and Medicare pays second . For inactive-duty military enrolled in Medicare, Medicare pays first and TRICARE may pay second .

Do I have to pay for Medicare if I have TRICARE?

When you use TRICARE For Life, you don't pay any enrollment fees, but you must have Medicare Part A and Medicare Part B. Medicare Part A is paid from payroll taxes while you are working.

Is TRICARE Medicare Part B?

TRICARE For Life is Medicare-wraparound coverage for retirees and their family members who are eligible for Medicare Part A and Part B. Learn how Medicare affects your TRICARE coverage at age 65.

Does TRICARE Prime need a referral if secondary?


Prime enrollees may receive clinical preventive services from any network provider without a referral or authorization. Urgent care visits do not require referrals. ... Prime beneficiaries must have a referral for clinical preventive services when they see a non-network provider.

What insurance company does TRICARE use?

Tricare is managed by the Pentagon's Defense Health Agency. Tricare is divided into several different types of coverage programs covering active-duty families, National Guardsmen and reservists and their families, and military retirees and their families.

What doesn't TRICARE cover?

In general, TRICARE excludes services and supplies that are not medically or psychologically necessary for the diagnosis or treatment of a covered illness (including mental disorder), injury, or for the diagnosis and treatment of pregnancy or well-child care.


TRICARE Select (previously named TRICARE Standard) is a preferred provider organization (PPO) health plan. A PPO provides the greatest choice in health care providers in exchange for some extra costs.

Can TRICARE for life be primary?

This means that Medicare pays first for health care services covered by both Medicare and TRICARE. TFL then pays the remaining amount. When you get care that's covered only by TFL (for example, TRICARE covered services received overseas), TRICARE processes your claim as the primary payer.

Does TRICARE cover spouse dental?

But not everyone is eligible for that coverage. Children up to age 21 or 23 can access it, while spouses and National Guard or Reserve members must be 23 or under. Also, any costs above and beyond the lifetime maximum must be paid out of pocket.

Is TRICARE considered a group health plan?

TRICARE (formerly known as CHAMPUS) is the Department of Defense's health care program for retired members of the uniformed services, as well as the spouses and children of active duty, retired and deceased service members. TRICARE is considered a group health plan for SEP and premium surcharge rollback purposes.

When BCBS payers for the primary and secondary policies are different?

If the payers for the primary and secondary or supplemental policies are different, submit a CMS-1500 claim to the primary payer.

What are third party payers?

Organization, public or private, that pays or insures medical expenses on behalf of enrollees. An individual pays a premium, and the payer organization pays providers' actual medical bills on the individual's behalf.

Do all veterans have TRICARE?

Does VA participate in the TRICARE Network? Yes, since 1995, all VA health care facilities have participated as TRICARE Network Providers. VA can provide care for Active Duty Service Members, military retirees, & family members under their TRICARE benefit - on a space available basis.

How does TRICARE insurance work?

TRICARE Select is a fee-for-service health plan, which is similar to a preferred provider organization, or PPO. You'll pay a set fee (copayment) or percentage (cost-sharing) every time you go to the doctor, but it'll be less for in-network providers than out-of-network providers.

Can I use TRICARE in a different state?

TRICARE beneficiaries can access medical care while traveling on business, vacation or when moving. However, all routine care should be obtained prior to travel, as this type of care may not be covered while away. Review the types of care below for additional coverage information.