TRICARE is a health care program benefitting uniformed military services members as well as their families. All TRICARE plans satisfy requirements for minimum essential coverage under the Affordable Care Act (ACA).
TRICARE Select (formerly called Standard/Extra) is a fee-for-service option for non-active duty service members. Although out-of-pocket costs for this coverage is higher, there is no referral requirement, and more freedom and options for providers are available, allowing the plan to function more like a PPO (Preferred Provider Organization). This option also has the added benefit of covering insureds while they travel overseas.
TRICARE Prime is a managed care option primarily offered for active duty service members, with comprehensive coverage offered. Some retired military members may also qualify for this coverage, but active duty members are automatically eligible. The plan offers a lower out-of-pocket cost, and in many cases, the plan requires referrals to see eligible service area providers, much like an HMO.
TRICARE Reserve Select (TRS) is a plan which functions similarly to TRICARE Select, but is only for military reservists and National Guard members. These individuals must not be under eligibility for other TRICARE coverage
What is the TRICARE Supplement?
The TRICARE Supplement is a voluntary insurance plan, designed to supplement what TRICARE already covers and assist with healthcare expenses for those who enroll. It also carries additional benefits for eligible dependents, as well as more choices for health coverage overall.
Who sponsors the program?
Selman & Company is the administrator and marketer of an employer-based plan sponsored by GEA USA (The Government Employees Association), underwritten by Transamerica.
Choosing the TRICARE Supplement Insurance plan will provide you with worldwide coverage that wraps around your TRICARE benefit plan to pay out-of-pocket expenses (cost shares, copayments and applicable excess charges). See Plan Details for specific plan features.
- Deductibles for services (see Plan Details for specifics)
- Copays (inpatient, outpatient, prescription drugs)
- Cost share (inpatient, outpatient, prescription drugs)
- Excess Charges (to the legal limit)
- No pre-existing condition limitations
- Guaranteed acceptance, no requirement for a medical examination
- No referrals /authorization required
- Prompt claims processing-generally 10 days or less in most cases
- Worldwide coverage
Termination and Portability
The TRICARE Supplement Plan is portable. That means it's available to you and your family members if you leave your employer for any reason. If you leave your employer and wish to continue enrollment, please contact Selman & Company to have your coverage converted. Please note that your premium remains the same but you would pay using post-tax dollars.
To be eligible for TRICARE Supplement Insurance you must be eligible for TRICARE, not eligible for Medicare and under age 65*, including:
- Military retirees who are entitled to retiree, retainer or equivalent pay.
- Retired Reservists enrolled in TRICARE Retired Reserves (gray area retirees).
- Retired Reservists between ages 60 and 65 and entitled to retiree pay.
- Spouses and surviving spouses of retired uniformed services members.
- Qualified National Guard and Reserve members (TRS-TRICARE Reserve Select).
Coverage is extended to your unmarried dependent children under age 21 (23 if a full-time student) or under age 26 if enrolled in TRICARE Young Adult (TYA) program. Incapacitated dependents must be enrolled prior to age 21 (23 if a full-time student) to continue the TRICARE Supplement Plan. Incapacitated dependents not enrolled prior to age limits will not be eligible for the supplement.
1) Members and their spouses age 65 or older but are ineligible for Medicare. These individuals must provide Selman & Company with a copy of the Social Security Administration ‘Notice of Disallowance’.
2) Members and their spouses age 65 or older but reside overseas. Since Medicare does not cover medical expenses incurred outside of the United States of America these individuals are eligible to enroll in TRICARE Supplement Insurance. However, these individuals must be entitled to Medicare Part A and be enrolled in Medicare Part B.
Please note that the TRICARE Supplement Plan may have different benefit eligibility requirements from your employer`s existing medical plans.
Check Your Eligibility
Eligibility for TRICARE is determined by the uniformed services and reported to DEERS. All eligible beneficiaries must have their eligibility status recorded in DEERS.
Filing your TRICARE Supplement Insurance claim is simple. Either you or your provider may file the claim. The claim submission MUST include the following:
- A completed and signed claim form
- 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.
Simply mail all three items to Selman & Company: Selman & Company, 6110 Parkland Boulevard, Cleveland, OH 44124.