TRICARE and CHAMPVA cover a lot, but not everything. Deductibles, cost shares, and co-pays still land on your bill. GEA's supplemental plans exist to help close those gaps, but the reimbursement only reaches you once a claim moves through several steps. Here is what happens, from the day your provider sends a bill to the day SelmanCo issues payment.
Most health care providers send claims straight to TRICARE or CHAMPVA on your behalf, either electronically or on paper. You rarely need to do anything yourself. When a provider does not submit for you, a claim form is available through SelmanCo, the administrator for GEA supplemental plans.
Before your supplemental plan pays anything, TRICARE or CHAMPVA reviews the claim and decides whether the service qualifies under program rules. Your supplemental plan follows this decision. A denial from TRICARE or CHAMPVA results in a denial from the supplemental plan. Supplemental insurance covers cost sharing left over after a primary program pays. Supplemental insurance does not cover services a primary program rejects.
Once TRICARE or CHAMPVA approves a service, SelmanCo's claims team reviews your supplemental claim. During this review, the team:
After this review, SelmanCo calculates your eligible cost sharing and issues reimbursement under your policy.
Denials usually trace back to one of two causes. The service falls outside what TRICARE or CHAMPVA covers, or required pre-authorization never happened before treatment. Supplemental plans follow the primary program's determination, so a denial at this level carries through to your supplemental claim. When this happens, SelmanCo helps you understand your explanation of benefits and answers questions about why a claim did not clear.
Providers handle most claims directly. When you need to submit one on your own, you can mail or fax the claim to SelmanCo's Claims Department. For more information on submitting a claim, please visit info.selmanco.com/submit-claim. Prefer to skip the mail? You can also submit documentation online through eService as covered below.
If you'd rather skip mailing or faxing paperwork, SelmanCo's eService portal now accepts claim documentation online. Here's how it works:
Once submitted, your claim goes through the same review process described above: TRICARE or CHAMPVA reviews it first, then SelmanCo reviews it under your supplemental plan.
Visit the eService portal to submit your claim online.
Want to see where a claim stands? You can view claim status within SelmanCo’s eService portal, and you can look over this guide for eService account creation instructions. Visit GEA's website for TRICARE and CHAMPVA supplemental options.
Hartford Life and Accident Insurance Company, part of The Hartford, underwrites GEA supplemental plans. SelmanCo administers the plans as a national third-party administrator. GEA operates as a nonprofit membership association, not an insurance carrier or government agency, and has offered these benefits to eligible members for years.
No. SelmanCo administers claims for GEA TRICARE and CHAMPVA Supplemental Insurance Plans. GEA sponsors the plan as a nonprofit membership association.
No. Supplemental plans follow the primary program's decision. A denial from TRICARE or CHAMPVA results in a denial from the supplemental plan.
SelmanCo checks each claim against your plan, deductible status, plan limits, and documentation requirements before issuing reimbursement. Contact SelmanCo directly for a status update on a submitted claim.
Insureds can check claim status within SelmanCo’s eService portal.
Do Medicare and CHAMPVA coverage work together?
Some people hold both Medicare and CHAMPVA coverage at the same time. Individuals with both do not qualify for a CHAMPVA supplemental plan.
Mail or fax the claim to SelmanCo's Claims Department or submit it online through the eService portal. A claim form is available through SelmanCo for all three claim submission methods.
Yes. SelmanCo's eService portal lets you upload claim documentation directly, so you don't have to mail or fax anything in.