TRICARE
Serving Veterans and Government Employees Since 1965

TRICARE Supplemental Insurance Plan


Your family’s health care costs can build up before you know it, especially if you need specialty care outside of the military system.

Helping Protect Your Family

TRICARE does not cover all expenses. In addition to deductibles, you might be on the hook for up to 25% of the cost of every covered prescription, doctor’s visit and hospital stay!

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This plan helps to reduce or eliminate your cost for

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Emergency Room Visits

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Doctor Visits

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Outpatient Procedures

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Excess Charges

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Hospital Stays

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Prescription Medications

TRICARE + Supplement Pays
100%

on Covered Medical Expenses*

You Could Pay
$0.00

on Covered Medical Expenses*


 

Helping Protect Your Family

The table below illustrates who pays with a TRICARE Supplement Insurance Plan. You must meet the Supplement Plan Deductible (Individual $250/Family $500) before the supplement pays.
NUMBERS BELOW ARE FOR TRICARE SELECT GROUP A PARTICIPANTS.
TRICARE Pays** Supplement Pays You Pay
TRICARE Deductible Individual $150 / Family $300 $0 $0 $150 / $300
Supplemental Plan Deductible Individual $250 / Family $500 $0 $0 $250 / $500
Doctor Visits In Network All but $30 to $118 $30 to $118 $0
Out of Network 75% 25% $0
Retail Network Pharmacy Co-Payments Generic RX All but $13 $13 $0
Brand Name RX All but $33 $33 $0
Non-Formulary RX All but $60 $60 $0
Other Out-of-Pocket Charges Excess Charges $0 100% $0

 

Competitively-Priced Premiums

As a GEA member, you benefit from the association’s mass purchasing power, making the rates for this valuable coverage more competitive.***
RATES BELOW ARE FOR TRICARE SELECT GROUP A PARTICIPANTS.
Age of Retiree, Spouse, Widow(er) Quarterly Rate with First Year Discount | Base Rate****
Under 40 $78.96 | $84
40 - 44 $84.60 | $90
45 - 49 $94.94 | $101
50 - 54 $119.38 | $127
55 - 59 $150.40 | $160
60 - 64 $166.38 | $177
Each Child $62.98 | $67
* After the TRICARE Deductible and TRICARE Supplement Plan Deductible have been met. Not to exceed 115% of the Tricare allowable amount for Tricare Select.
** Check with TRICARE to confirm your actual deductible and co-pay portion. TRICARE’s portion of coverage is provided here for your convenience, but is subject to change by Defense Health Agency; visit www.tricare/mil for the most up-to-date information. The Supplement Insurance reimburses for co-pay costs for covered services after deductibles have been met.
*** Rates and/or benefits are based on the attained age of the Insured Person and increase as the Insured Person enters each new age category. Rates and/or benefits may be changed on a class basis. Plan or rate changes may be subject to final approval by the applicable regulatory authorities.
**** First year discounted rates are not available to insureds in OH or KY. Members receive a 6% rate discount during their first twelve months of coverage. There are no other discounts. After the 12th month, the rates go up 6%.

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Am I eligible?

If you’re enrolled in TRICARE you can obtain this coverage. This includes the following individuals:

  1. Military retirees and their families
  2. Spouses/children of active duty service persons
  3. National Guard and Reserve members and their families

WHAT IS COVERED?

The supplement pays eligible out-of-pocket expenses, after any applicable deductible, as follows:

  • 100% of TRICARE co-pays and cost shares
  • 100% of excess charges above the TRICARE Select allowable amount, not to exceed the legal limit of 115% of the TRICARE allowable amount
  • 100% of cost shares and excess charges for Prime point of service
  • 100% of the daily subsistence from a government facility
  • The daily inpatient charges from the first day

PRE-EXISTING CONDITIONS LIMITATION

If you or your covered dependents received medical care for an injury or sickness during the six months before the date your coverage begins, coverage of that condition won’t start until the person has been enrolled in the plan for six months.


COMMON QUESTIONS AND CONCERNS

These conversations are fictitious and for illustrative purposes. Have additional questions? Call a TRICARE Supplement Insurance Plan Specialist at 888-214-0794.

 

Elliot: How does the TRICARE Supplement work with drug co-pays?

TRICARE Supplement: If TRICARE covers that prescription, your supplement plan will reimburse the co-pays after your deductibles are met.

 

Janet: My husband is going through a psychiatric treatment of about 39 treatments. A co-pay every time. How would we be reimbursed?

TRICARE Supplement: Co-payments are paid when a claim is submitted after a deductible(s) is met (if applicable). After the co-payments are paid, submit the claim to be reimbursed.

 

Mike: I am a Tricare Prime Retiree and have excess out-of-pocket expenses. How can this supplemental coverage help me? What are the costs of something like this?

TRICARE Supplement: The supplement is designed to cover excess out-of-pocket expenses! Call for more details or to request additional information.

 

Sam: Our son has been recently diagnosed as a Type 1 diabetic. We’re looking for insurance assistance for glucose monitors and insulin pumps. He is age 15.

TRICARE Supplement: We can definitely help your family! There is a six-month waiting period for pre-existing conditions, but once that time has passed, we will pick up the portion that TRICARE does not pay.

 

Jim: I recently got a prescription and TRICARE didn’t pay any of it. Will my Supplemental Plan cover it?

TRICARE Supplement: TRICARE covers most prescription drugs approved by the Food and Drug Administration. Unfortunately, if TRICARE does not cover your prescription, your Supplemental Plan will not either.

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The savings examples are for illustrative purposes only. Actual savings may vary by case. TRICARE’s portion of coverage is provided here for your convenience, but is subject to change by DHA (Defense Health Agency); Visit www.tricare.mil for the most up-to-date information. Important Documents: All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations and terms under which the policies may be continued in force or discontinued. Read details for your type of supplement insurance plan: TRICARE Prime | TRICARE Select | TRICARE Active Duty

The TRICARE/CHAMPVA Supplement Insurance Plans are administered by SelmanCo. Underwritten by: Hartford Life and Accident Insurance Company, One Hartford Plaza, Hartford, CT 06155. TRICARE Form Series includes GBD-3000, GBD-3100, or state equivalent. Policy Numbers: AGP-5925, AGP-5926. Not available in all states.
 
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