Tricare Help

Tricare and Medicare: Each case is different

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Q. My son is disabled and has received a Medicaid card. How does that work with Tricare?

By federal law, Tricare is your son’s primary health insurance. Use Medicaid as second payer to Tricare if he receives medical services that are not covered by Tricare.

Depending on the situation in any given case, how Tricare and Medicaid work together varies. Such things can be decided only after medical care is received and claims have been filed.

For questions about your particular situation, call your Regional Tricare Service Center.

How does Tricare coordinate with FEHB, Medicaid?

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Q. I am a federal employee and a mobilized reservist on active duty, so I have my FEHB – AETNA as well as Tricare. I recently found out that my son, who has Cerebral Palsy, is covered by Medicaid. He had major surgery after I was mobilized. How are the benefits coordinated?

By law, Tricare is always last payer to all other health insurance, medical plans such as HMOs, or medical payments such as you might receive from an auto accident, slip-and-fall injury and the like.

The only exceptions to that rule are in the case when the other coverage is a bona fide, specially written Tricare supplement, or a welfare-related plan such as Medicaid (not Medicare), Indian Health Service, and the like.

In your son’s case, the order of filing will depend on his coverage.  If he has Aetna, those claims must be filed first.  Then you can file with Tricare (which will probably pay all, or most, of Aetna’s deductibles and copayments), and finally claims can be filed with Medicaid.