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Learn About TRICARE Supplemental Insurance
By enrolling in Tricare Supplement Insurance, active duty military members who have Tricare insurance can receive assistance in paying for out-of-pocket medical costs. A Tricare supplement plan can help aid in specific medical costs that are not necessarily covered under the umbrella of the Tricare plan. However, before enrolling in supplemental insurance through Tricare, it is important to understand who is eligible and what the essential benefits include.
A supplement plan is not a health insurance plan like Tricare or Medicare, but instead it acts as an additional coverage insurance plan on top of regular benefits. Before enrolling in the supplement plan, military members should understand what the Tricare insurance plan covers and if more is necessary to fit their needs. To learn more about the benefits of receiving Tricare supplemental insurance plans, continue reading below.
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What is a TRICARE supplement insurance plan?
Military members who enroll in Tricare insurance have the option of adding Tricare supplement insurance to their existing benefits. Supplemental health insurance is not a health insurance plan by itself, but instead it is an add-on plan that covers additional benefits that a regular plan would not, like paying for certain medications from the military pharmacy. Regular insurance plans like Tricare cover the costs to see a doctor, receive approved services and visit a hospital or an outpatient facility. Tricare Supplemental insurance plans involve secondary costs to be covered outside of the regular plan, which can include deductibles, copayments and coinsurance. A supplemental insurance plan acts as a safety net so that insured applicants do not get hit with unplanned out-of-pocket costs. For more information about Tricare insurance supplemental plans, download our comprehensive guide.
What does the TRICARE Supplement pay for?
Tricare supplemental insurance providers cover specific costs that tend to fall outside the scope of basic TRICARE coverage. A few of the items that Tricare Supplement insurance pays for include:
- Up to 100 percent outpatient deductibles.
- Up to 100 percent of out-of-pocket costs for covered services.
- Up to 100 percent of copayments and coinsurance for Tricare.
- Up to 100 percent of doctor visits, pharmacy visits and copayments.
- Daily inpatient charges from the first day.
An example of Tricare additional insurance benefits would be for an active duty military member who sees a specialist for a minor procedure. If he or she has a $300 copayment or coinsurance after using Tricare, those costs would be considered out-of-pocket expenses. However, with Tricare Supplement, the out-of-pocket costs could be greatly reduced. This supplemental insurance plan can help with other costs as well, including prescriptions or copayments that accompany every refill. Anyone who had out-of-pocket expenses frequently or through regularly scheduled medical services should consider adding a supplement plan to their regular benefits.
What will a TRICARE Supplement plan not pay for?
While there are many costs that Tricare supplement insurance will cover for an enrollee, there are also other costs that will not be covered. A Tricare insurance supplement plan will not cover:
- Any outside healthcare services not covered through Tricare.
- Tricare Prime enrollment fees.
- Any healthcare services rendered before enrolling in a Tricare plan.
- Charges incurred for services excluded by Tricare.
- Deductible amounts for the Tricare Prime Point of Service option.
- Charges incurred for pre-existing conditions.
- Charges for which the supplement plan is not legally obligated to pay.
Before military members and their dependents enroll in a supplement insurance plan through Tricare, they should understand their out-of-pocket healthcare costs and see whether the supplement’s premiums will be offset by those costs in a beneficial way.
What should you do before choosing a TRICARE Supplement plan?
Before a Tricare member enrolls in a Tricare Supplement plan, he or she should first determine whether or not it will be beneficial. Each supplement plan will have its own rules, which means it is important to consider an insurance member’s healthcare needs before making a decision. A few questions to ask in order to find an answer to whether or not this supplement plan is worth it included:
- What type of health care services will it cover?
- How many costs will be covered beyond regular TRICARE insurance?
- How much are the supplement premiums?
- How often does the supplement premium need to be paid?
- Will the premium rates change depending on military status or age?
- Do certain treatments need to be pre-approved?
- Is there a pre-existing condition clause?
- How do I file a claim?
Finding the answers to these important questions can help Tricare members understand whether or not an additional insurance plan will help offset out-of-pocket costs. To find out more about determining whether or not a Tricare supplement is worth it, download our full guide to learn more.
How much does a TRICARE Supplement plan cost?
A common question surrounding Tricare supplemental insurance plans is how much the plan will cost. Before an enrollee chooses to enroll in Tricare supplement insurance, he or she should understand the costs that surround the additional plan. The actual cost of an add-on plan varies depending on a person’s age, the deductible, as well as the number of beneficiaries. Enrollees can pay less than $200 annually for a supplement plan if they are under the age of 50 and opt for a higher deductible. On the other hand, enrollees who choose a low deductible option may pay upwards of $600 annually.
Adding children to the supplement plan can also add to the higher costs of premiums. When choosing a supplemental plan, enrollees should be aware of the out-of-pocket caps for a particular plan. For instance, if a certain plan has an annual cap of $4,000, this means that the supplement plan pays up to $4,000 for the out-of-pocket costs. Before a military member chooses one of the supplemental insurance policies, he or she will be able to receive quotes for different plans through the Tricare insurance website.