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Learn About TRICARE Insurance in Ohio

TRICARE is a health insurance program offered by the U.S. government for military service members, veterans and their families. As a federal program, TRICARE offers a variety of health care plans based upon eligibility criteria and individual needs. In general, beneficiaries may receive the following benefits with TRICARE insurance:

  • Medical care
  • Vision care
  • Special needs services
  • Dental care
  • Mental health services

Over 160,000 individuals are members of TRICARE health insurance in Ohio, and an estimated 9.4 million members are covered around the world. Read on to learn more about the specific requirements for obtaining TRICARE, as well as its coverage options and potential costs. Otherwise, you may download our comprehensive guide now.

What are the TRICARE requirements in Ohio?

Determining who qualifies for TRICARE depends on an individual’s relationship to the military. In order to enroll in TRICARE, an individual must:

  • Be an active duty uniformed service member or part of the member’s family.
  • Be a member of the Reserves/National Guard or part of the member’s family.
  • Be a survivor or former spouse of a service member.
  • Be a Medal of Honor recipient or part of the recipient’s family.
  • Be any other individual eligibility registered in the Defense Enrollment Eligibility Reporting System (DEERS).

Depending on how an applicant meets the Ohio TRICARE eligibility requirements, they will qualify to receive different types of coverage and pay for different coverage amounts. However, all individuals must be registered in DEERS to receive any coverage. In general, active duty service members are automatically registered in the program and may enroll family members to satisfy the requirements for DEERS eligibility.

Download our comprehensive guide for more details on TRICARE requirements.

How to Apply for TRICARE in Ohio

The TRICARE enrollment process varies depending on each individual plan. However, you can generally begin the TRICARE enrollment online, by phone or by mail. In any case, make sure that the application method you choose is available for the desired health plan you would like. For instance, overseas applicants are not eligible for online enrollment.

Furthermore, keep in mind that while premium TRICARE policies may be purchased at any time, TRICARE Prime and TRICARE Select enrollment is only open in the fall or after a qualifying life event. Finally, be mindful that you will not have to sign up for TRICARE for Life if you are eligible for it.

If you choose to apply by mail, it is important to make sure that you send the TRICARE enrollment form to the correct address, which may vary based on your location. For more information on how to complete the TRICARE enrollment process, download our free guide.

Learn About TRICARE Costs and Coverage in Ohio

TRICARE benefits in Ohio vary based on the type of plan you choose to enroll in. However, TRICARE coverage generally covers:

  • Medical care
  • Dental procedures
  • Vision care
  • Services for special needs
  • Mental health services

TRICARE plans also cover prescriptions with four options of retrieval. You can get TRICARE covered prescriptions from military pharmacies, network pharmacies and non-network pharmacies, or you can get them delivered directly to your home. Additionally, you should familiarize yourself with any potential rules regarding filling the medications you may need.

Just like the kind of coverage that you will be eligible receive, TRICARE costs will vary depending on the plan that you choose. Moreover, costs will vary based on the eligibility requirements that you meet.

Despite the fact that active duty service members will not be required to make a TRICARE payment for any service that they receive, other beneficiaries may have to. Higher costs and even a TRICARE copay may be applied when a beneficiary receives out-of-network care or does not acquire the necessary referrals for care.

To learn more information about TRICARE cost and coverage options, download our guide.

How to File a TRICARE Claim in Ohio

TRICARE claims are typically filed by individual providers. However, if you are traveling or receive care from an out-of-network provider, you must file the claim yourself. Claims can be filed by mail or online if you are an overseas service member. In any case, it is important to fill out the proper TRICARE claim form and mail it to the correct office in order to receive reimbursement.

Claims are usually processed within 30 days of receipt. You may check your TRICARE claim status by registering on your claim processor’s website, which varies depending on your location. If your claim is denied and you believe that it is due to an error when filing, you may refile it in order to receive your TRICARE reimbursement. However, if the claim was denied for another reason, you must either contact your claims office or file an appeal.

For more information on how to file a TRICARE claim, download our free guide now.