TRICARE + TRICARE Supplement Insurance Plan
Families who are eligible for government-sponsored TRICARE health insurance can get help saving on co-pays, prescriptions, and cost shares. A TRICARE Supplement Insurance Plan helps reimburse you for covered expenses that TRICARE doesn't pay.
- TRICARE is the Department of Defense’s healthcare program for military personnel and their families. More than seven million Americans are eligible to participate in this type of coverage. All TRICARE plans satisfy requirements for minimum essential coverage under the Affordable Care Act (ACA). Learn more at tricare.mil.
- A TRICARE Supplement Insurance Plan is a voluntary benefit program that covers many of the charges the government leaves behind. It helps employees (TRICARE beneficiaries), spouses, and dependents limit their out-of-pocket expenses
(Note: The pre-tax benefit is available if premium payments are set up as a payroll deducted benefit.)
Features & Benefits
Features
- Covers cost shares and co-pays (inpatient, outpatient, prescription drugs)
- Covers excess charges (to the legal limit)
- Compatible with most types of government TRICARE plans
- No referrals /authorization required
- No pre-existing conditions limitations
- Guaranteed issue (no requirement for a medical examination)
- Offered on a pre-tax basis if premium payments are made via payroll deduction
- When premium payments are made via payroll deduction, the plan is fully portable, even if employment ends for any reason (If you leave your employer and wish to continue enrollment, please contact SelmanCo to have your coverage converted. Please note that your premium remains the same but you would pay using post-tax dollars.*)
*This information is written in connection with the promotion or marketing of the matter(s) addressed in this material. The information cannot be used or relied upon for the purpose of avoiding IRS penalties. These materials are not intended to provide tax, accounting or legal advice. As with all matters of a tax or legal nature, you should consult your own tax or legal counsel for advice.
Benefits
- Wraps around existing TRICARE coverage to reimburse for out-of-pocket expenses
- Helps create cost certainty for annual health care costs
- Adds provider choice for employees with TRICARE Prime (an HMO-style plan with out-of-network charges)
Eligibility
Employees or spouses must be eligible for TRICARE to qualify for the TRICARE Supplement Insurance Plan. These are typically employees or spouses who are retired military personnel, not eligible for Medicare, and under age 65. Military retirees, retired reservists, their spouses, and dependent children can be covered by TRICARE + TRICARE Supplement Insurance, subject to eligibility requirements.
Eligibility for TRICARE is determined by the uniformed services and reported to DEERS. All eligible beneficiaries must have their eligibility status recorded in DEERS.
Claims
Most health care providers will process your claims for you if you provided them with your TRICARE and TRICARE supplement insurance cards. If you need to file a claim yourself, please provide those items directly to SelmanCo. Include:
- A completed and signed claim form: Claim Form (PDF, 68k)
- A copy of your provider’s bill showing the diagnosis, provider’s name, address and Tax ID number
- A copy of the corresponding TRICARE Explanation of Benefits (TEOB) statement.
Mail all three items to:
SelmanCo
PO Box 14043
Lexington, KY 40512
