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TRICARE and Other Health Insurance

Many TRICARE beneficiaries have health insurance coverage from sources other than TRICARE.  This “Other Health Insurance” (OHI) may be available through an employer, an association, a private insurer, school health care coverage for students, or a TRICARE supplemental insurance entitlement program such as Medicare. Although there are a few exceptions (such as TRICARE supplemental insurance), federal law requires TRICARE to be the secondary payer to OHI.

Beneficiaries must file with their OHI provider before filing with TRICARE. A copy of the beneficiary’s OHI payment determination and a copy of the itemized bill should be included with the TRICARE claim form. If the provider doesn’t file TRICARE claims on their behalf, beneficiaries must remember to submit claims to TRICARE after their OHI pays. It is essential beneficiaries understand their OHI so they know how the provider network, referral, prescription and claims processes work. To clarify some specifics on how OHI works with TRICARE, check out TRICARE’s web page on OHI at http://tricare.mil/OHI.

TRICARE beneficiaries may also choose to purchase a TRICARE supplemental insurance policy offered, for example, by FRA, other military associations and private companies. Unlike OHI, which pays for health care services before TRICARE, these supplemental programs pay after TRICARE.

Knowing OHI policies is critical to making choices in healthcare plans and TRICARE officials urge all beneficiaries to become more familiar with OHI and how it can affect their TRICARE benefit.  Beneficiaries with OHI who need more information on how to file claims can visit www.tricare.mil/claims for details and forms.