TRICARE vs. TRICARE Supplement Insurance: Common Questions Answered | SelmanCo

As a member of the military community, you’ve earned valuable health care benefits through TRICARE, the Department of Defense’s official health care program for active-duty service members, retirees, and eligible family members.

However, TRICARE doesn’t cover every out-of-pocket cost, and that’s where a TRICARE Supplement Insurance plan can play an important role in your overall financial protection. This blog answers common questions to help you decide what’s right for you.

What is TRICARE?

TRICARE is the U.S. military’s health care program that provides comprehensive medical benefits, including medical care, hospital care, and pharmacy services, to qualifying beneficiaries. Plans vary based on your status, for example TRICARE Prime, TRICARE Select, and others, but all operate under the Department of Defense with coverage rules, cost-shares, and eligibility defined by the Military Health System.

TRICARE is primary insurance, meaning it pays first under most circumstances when you receive care. Learn more about TRICARE plans and eligibility on the official TRICARE website.

What is TRICARE Supplement Insurance?

A TRICARE Supplement Insurance plan is secondary, voluntary insurance designed to work alongside your existing TRICARE coverage. It helps pay costs TRICARE doesn’t cover, such as co-pays, cost-shares, deductibles, prescription expenses, and excess charges, after TRICARE pays its portion.

According to SelmanCo, this plan “wraps around your TRICARE health insurance coverage” so you can reduce or even eliminate many out-of-pocket costs. You can read more about how this works on SelmanCo’s TRICARE Supplement page.

How Do They Work Together?

Here’s the basic sequence when you use both plans:

• You seek care.
  You receive medical services covered by TRICARE.
• TRICARE processes the claim first.
  TRICARE pays according to its cost-share and deductible rules, which are outlined on TRICARE’s cost and coverage resources.
• The supplement plan pays second.
  A TRICARE Supplement Insurance plan may reimburse you for many TRICARE cost-shares, co-pays, and other qualifying expenses you pay yourself, subject to the supplement’s terms and deductible.

Who Can Use Each?

• TRICARE: Eligible for active-duty service members, retirees, National Guard and Reserve members, and family members who meet TRICARE eligibility and enrollment requirements. Full eligibility details are available on TRICARE’s eligibility page.
• TRICARE Supplement Insurance: Available to those who already have TRICARE and want extra financial protection against out-of-pocket costs. SelmanCo’s supplement is typically best for beneficiaries who are not on active duty and not eligible for Medicare, such as retirees, spouses, and dependent children. Availability details can be found on SelmanCo’s TRICARE Supplement page.

What Does a TRICARE Supplement Plan Cover?

Coverage varies by plan, but common features include:

• Assistance with TRICARE co-pays and cost-shares for doctor visits, hospital stays, and prescriptions.
• Coverage of eligible excess charges up to legal limits, with provider-related details available on SelmanCo’s health care providers page.
• Reimbursement for costs that would otherwise fall entirely on you after TRICARE pays.

Important: a TRICARE Supplement plan is secondary. If TRICARE doesn’t cover the service at all, the supplement typically won’t either. Always review your policy terms, which SelmanCo explains further on its health care providers page.

Frequently Asked Questions

Q: Do I still need TRICARE if I have a supplement plan?
Yes. A TRICARE Supplement plan does not replace your TRICARE benefits. It supplements them. You must have TRICARE first, because the supplement pays only after TRICARE has paid its portion.

Q: Will a supplement pay for services TRICARE denies?
Generally no. Because the supplement is secondary to TRICARE, it typically only helps with costs TRICARE already approves. Services TRICARE doesn’t cover usually won’t be covered by the supplement. Additional clarification can be found on SelmanCo’s health care providers page.

Q: Are TRICARE Supplements available everywhere?
Availability can vary by state, and some plans may not be offered in all locations. Always confirm plan availability before enrolling.

Which Should I Choose?

• If you want primary health coverage with defined benefits for eligible military members and families, then TRICARE is your foundation. Visit TRICARE’s official site for plan details.
• If you want extra financial protection to help cover what TRICARE leaves behind, a TRICARE Supplement Insurance plan can be a valuable addition. SelmanCo explains these benefits further on its TRICARE Supplement page.

Final Thoughts

Understanding how TRICARE and TRICARE Supplement Insurance work together empowers you to make informed decisions about your healthcare finances. TRICARE provides essential coverage backed by the Department of Defense, and a supplement plan from SelmanCo can help fill in cost gaps, giving you greater peace of mind.

If you’d like help comparing plan options or understanding how a supplement might specifically benefit your situation, reach out to our customer service team through SelmanCo’s website. We’re here to support you every step of the way.