• Military retirees entitled to retired, retainer or equivalent pay.
   
• Spouses, surviving spouses and some former spouses of Active-duty service members or retired military personnel.
   
• Retired Reservists and National Guardsmen between the ages of 60 and 65 with 20 years of creditable service.
   
• Reservists and National Guardsmen who are enrolled in TRICARE Reserve Select. Their spouses and dependents are also eligible
   
• Reservists and National Guardsmen and family members who are enrolled in TRICARE Reserve Select (TRS).
   
• Reservists and Guardsmen who separate from active duty and family members who have temporary health benefits for 180 days under Transitional Assistance Medical Program (TAMP) (such individuals will be eligible under the Supplement plan for 180 days)
   
• Spouses, surviving spouses, former spouses, and dependent children of service disabled veterans that are eligible for CHAMPVA.
  
   

Q. Up to what age are dependents eligible?
A. Dependents are eligible up to age 21, and up to age 23 if a full-time student.

Q. Are incapacitated dependents eligible for coverage?
A. An incapacitated dependent is eligible for coverage during an open enrollment period providing he/she continues TRICARE eligibility.

The dependent incapacitated child of a new member is eligible if application is made within the specified eligibility period of the member.

Q. Are pre-existing conditions covered under the Supplement?
Please contact us to find out more at 800-638-2610 x255

Q. How does the Supplement coordinate with TRICARE?
A. With the Supplement, TRICARE is the primary payer and the Supplement is secondary. Thus, you are able to take full advantage of your military benefits. Your claims are filed first with TRICARE, then the TRICARE Explanation of Benefit (EOB) Statement is sent to the Supplement. The Supplement will pay for your TRICARE cost share and any applicable excess charges.

Q. How does the Supplement coordinate with TRICARE Standard/Extra?
A. TRICARE Standard and Extra are interchangeable. You can go to any authorized provider under TRICARE Standard or any network provider under TRICARE Extra. You have freedom of choice when visiting a doctor. TRICARE pays 75% of the TRICARE Standard allowable amount or 80% of the TRICARE Extra negotiated amount, after your $150 individual/$300 family deductible has been met.

In most cases, the Supplement reimburses 100% of the eligible charges not paid by TRICARE. It pays 100% of your TRICARE Standard deductible¹, plus your 20% cost share under Extra or your 25% cost share under Standard and 100% of applicable excess charges when providers do not accept assignment or when nonparticipating providers are used.

Q. How does the Supplement coordinate with TRICARE Prime?
A. TRICARE Prime is a strict HMO plan, and requires a referral to see any doctor other than your primary care physician (PCM). As long as you use the military facilities under TRICARE Prime, you have no out of pocket expenses. When you use civilian doctors in the TRICARE Prime network of providers, you are responsible for copayments.

The Supplement will reimburse all TRICARE Prime copayments.

If you see an out-of-network doctor without a referral, you are using the Point of Service (POS) option under TRICARE Prime. Under the POS option, you may have large out of pocket expenses. You first have to pay a $300 individual/$600 family deductible. After the deductible is met, TRICARE pays 50% of the allowable amount. You are responsible for the other 50%, and for any applicable charges that exceed the TRICARE Prime POS allowed amount.

The Supplement will pay half the POS deductible, the 50% cost share, plus 100% of applicable excess charges.

Q. If I currently have TRICARE Prime, and would like to take the Supplement, can I change from Prime to the Standard/Extra option?
A. Yes. When you have TRICARE Prime, the Supplement is offered as a transitional benefit. The supplement will coordinate with TRICARE Prime while you have Prime. Once you transition to TRICARE Standard/Extra, the Supplement will coordinate with Standard/Extra.

The Department of Defense recommends that beneficiaries enrolling in TRICARE Prime pay the enrollment fee on a quarterly basis. If a beneficiary decides to drop out of TRICARE Prime, he/she can stop making payments at the end of the quarter. The beneficiary will be given a 30-day grace period to make the payment. If payment is made after 30 days then coverage will automatically revert to TRICARE Standard.

If the TRICARE Prime enrollment fee is paid for the entire year and the beneficiary drops out of Prime prior to the end of the enrollment year, the portion of the unused enrollment fee will not be refunded.

Q. How are prescription drugs covered under the Supplement?
A. Most pharmacies are in the TRICARE network and are linked electronically to TRICARE. When a network pharmacy is used, you will pay a copayment of $3 for generic and $9 for brand name drugs or $22 for non formulary drugs. Your prescription drug co-pay receipt (showing the name of the drug, date filled, and copayment amount) should be sent to the Association & Society Insurance Corporation (ASI) for reimbursement.

If an out-of-network or nonparticipating pharmacy is used under TRICARE Standard, you will pay the TRICARE Standard deductible plus $9 or 20% for generic or brand name drugs or $22 or 20% for non-formulary drugs, whichever is greater. If used under TRICARE Prime POS, you will pay the POS deductible plus the 50%POS cost share. The TRICARE Explanation of Benefit (EOB) Statement should be sent to ASI for reimbursement of $150 individual or $300 family deductible plus $9 or 20% or $22 or 20% of the cost or the 50% cost share.²

Q. How are claims filed with the Supplement?
A. With the Supplement, claims are filed first with TRICARE. After TRICARE has processed your claim, they will send you an Explanation of Benefit Statement (EOB). Simply write your certificate number on the EOB and also, write "Pay Provider" if you would like the benefits paid directly to the provider, otherwise the benefits will be paid to you.

Claims may be mailed to:
ASI, P.O. Box 2510, Rockville, MD 20847


If the provider submits claims to ASI for the Supplemental coverage, there is no need for you to submit your claim.

Q. Do most providers submit claims to TRICARE and ASI?
A. According to TRICARE, 98% of providers submit claims directly to TRICARE. Most providers will also submit claims directly to ASI for the Supplemental coverage. You should always ask your provider to file your supplemental claim for you.

Some providers do not participate with TRICARE because they do not want to accept the TRICARE allowable amount as payment in full. With the TRICARE Supplement as secondary coverage, this is not an issue. The Supplement will pay 100% of applicable excess charges over the TRICARE allowable amount when you use out-of-network providers.

Q. What happens when I reach age 65?
A. At age 65, the TRICARE Supplement ends. You must be eligible for Medicare Part A and enrolled in Medicare Part B to continue TRICARE eligibility. TRICARE turns into TRICARE for Life and becomes the secondary payer to Medicare.

If you are not eligible for Medicare or live out of the country, the TRICARE Supplement will continue past age 65.

Q. Who is the Underwriter for the TRICARE Supplement Plan?
A. Underwritten by Hartford Life and Accident Insurance Company, Simsbury, CT 06089.

¹This only apply's to new corporate customers
²Deductible is reimbursed for new corporate members

                          Note: These entities are not affiliated with the TRICARE Supplement in any way.