Is TRICARE considered a group health plan?

Asked by: Melba Bode  |  Last update: February 9, 2022
Score: 4.8/5 (39 votes)

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.

What type of health insurance is TRICARE?

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

Is TRICARE for Life considered a group health plan for Medicare?

Keeping your information up to date in the Defense Enrollment Eligibility Reporting System (DEERS) is key to ensuring effective, timely delivery of your TRICARE benefits. ... TRICARE For Life is Medicare-wraparound coverage for retirees and their family members who are eligible for Medicare Part A and Part B.

Is TRICARE a health plan?

TRICARE is the worldwide health care program for uniformed service members and their eligible family members. Your eligibility and location determine which particular plans are available to you. Most TRICARE health plans feature comprehensive health care coverage and a pharmacy benefit.

Is TRICARE considered private insurance?

TRICARE supplements don't qualify as "other health insurance."." It can be through your employer or a private insurance program. By law, TRICARE pays after all other health insurance, except for: ... Other Federal Government Programs identified by the Director, Defense Health Agency (i.e. Indian Health Service)


26 related questions found

Is TRICARE public insurance?

What is TRICARE? Public systems account for over a third of all health insurance in the US, and TRICARE is one of them. TRICARE is a health care program benefitting uniformed military services members as well as their families.

Is TRICARE primary or secondary 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).

What is TRICARE Group A coverage?

You're in Group A if your initial enlistment or appointment or that of your uniformed services sponsor began before Jan. 1, 2018. If you're a Group A retired beneficiary, you now pay a monthly TRICARE Select enrollment fee to maintain your TRICARE Select coverage. This is for coverage that started on Jan. 1, 2021.

What is my TRICARE group number?

Department of Defense (DoD) Benefits Number

The DoD Benefits Number (DBN) is an 11-digit number on the back of the ID card. It verifies your TRICARE eligibility and helps you to file your claims. This is the number your doctor's office will need to use to file claims.

What are TRICARE plans?

TRICARE is the health care program for members of the military, retirees, and their families. TRICARE provides a wide range of services, such as medical care, prescription medications, and dental and vision coverage.

Is there a difference between TRICARE and TRICARE for Life?

TRICARE is a health insurance program provided by the federal government to active duty and retired military personnel and their family members. ... TRICARE for Life (TFL), a program for Medicare-eligible military retirees and their dependents, acts as a supplement to Medicare.

Are spouses covered under TRICARE for Life?

Nothing. The good news is your family's existing TRICARE coverage doesn't change. Your spouse can remain in his or her TRICARE plan. And if you have children, they remain in their current plan until they change plans or lose TRICARE eligibility.

Is TRICARE free for spouses?

Spouses of active duty, reserve and retired members are eligible for TRICARE coverage. Dependents of active and retired members are automatically covered as soon as they are enrolled to DEERs, spouses of reserve members must purchase TRICARE Reserve Select if they want TRICARE coverage.

What are the three types of TRICARE coverage?

To learn more about each plan, select from the list below: TRICARE Plus. TRICARE Prime. TRICARE Prime Remote.


TRICARE PRIME. TRICARE Prime is a Health Maintenance Organization (HMO) medical plan. HMOs provide guaranteed access to health care by assigning you to a specific facility for your care.

How do I know what type of TRICARE I have?

Get Proof of TRICARE Coverage
  1. Log in to milConnect.
  2. Click on the “Obtain proof of health coverage” button.
  3. Or click on Correspondence/Documentation and choose "Proof of Coverage."
  4. Your coverage letter will be generated and available for download.

What is a group number for insurance?

Group number: Identifies your employer plan. Each employer choses a package for their employees based on price, or types of coverage. This is identified through the group number. If you purchased your insurance through the health exchange you might not have a group number.

What is TRICARE Prime Group B?

You're in Group B. if your initial enlistment or appointment or that of your uniformed services sponsor began after Jan. 1, 2018. Most Group B beneficiaries are already paying TRICARE Select enrollment fees.

What is the TRICARE East group number?

(800) 444-5445.

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.

What is TRICARE direct care only coverage?

If you're a dependent parent or parent-in-law and you get care only at military hospitals and clinics, your ID card will say "direct care only" on the back. ... This is when your regional contractor refers you to a military hospital or clinic first.

How many TRICARE plans are there?

TRICARE offers ten different health plan options to provide coverage to millions of beneficiaries around the globe.

Is TRICARE primary to BCBS?

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

Is TRICARE considered Medicaid?

TRICARE is the Department of Defense's health benefits program for U.S. Armed Forces military personnel, veteran retirees and their dependents. According to the Medicaid and CHIP Payment and Access Commission (MACPAC), nearly one million TRICARE beneficiaries also have coverage through Medicaid.

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.