When we travel overseas, will our Tricare for Life take care of any emergency medical needs?
Yes, you will still be covered. However, the Tricare Standard portion of Tricare for Life will be your only coverage because Medicare does not operate outside the U.S. and its territories.
Tricare Standard would be your primary payer, and you would still be responsible for paying normal Tricare deductibles and cost shares for any medical care you need while overseas. Filing claims works a bit differently for care received overseas; you should be prepared to pay for medical care up front and then would have to file paper claims for reimbursement with your Tricare for Life contractor. Make sure to save all bills and receipts.
I am retired military on Tricare Prime. My wife and I will be traveling to Europe on vacation. If either of us have a medical emergency while overseas, are we covered by Tricare Prime? If so, what is covered, and is there anything we need to do before we leave?
Yes, you absolutely remain covered by Tricare Prime while traveling overseas. You are covered for anything that Tricare Prime normally covers, which is essentially any medically necessary care. However, there are a few differences in the rules when a beneficiary is traveling overseas. The major difference is that if you must seek care from a host-nation provider while overseas, you should be prepared to pay up front for the health care services and then file a claim for reimbursement yourself with the Tricare Overseas Program claims processor. The same goes for any prescription medications you may need to obtain from host-nation pharmacies. Keep copies of all receipts and bills.
I am a retired service member living overseas. My wife and I have successfully used the Tricare overseas program for nine years. When I reach age 65, will my wife and I still be able to use it? I understand that if I live in the U.S. I would have to enroll in and use Medicare Part B at 65. Since Medicare is not available overseas, it will not be an option for us.
You may continue to use Tricare overseas after reaching age 65, but a big quirk will come into play: You will have to enroll in Medicare Parts A and B, and pay the monthly Part B premiums — even though you will not be able to use Medicare while living overseas. Enrollment in Medicare Part B is a bedrock requirement to be eligible for Tricare for Life. If you’re willing to pay that cost (Part B premiums are currently about $100 per month per beneficiary), then you may use Tricare Standard overseas, which will serve as your primary payer. You’ll be responsible for all applicable cost-shares and deductibles under Standard.
My wife and I are Tricare for Life beneficiaries. We are traveling to Europe this winter and realize that while our Medicare will not cover us overseas, Tricare will provide a degree of coverage. We purchased “trip insurance,” which includes a medical portion. The trip insurance says they are the second payer, although I have heard that Tricare is always the second payer by federal law. Which will actually pay first?
You correctly note that by law, Tricare must be last payer to all other health insurance. But there is one exception to that rule: Tricare is first payer to supplemental insurance coverage, a category into which your short-term travel policy falls. Supplemental insurance pays after Tricare pays its portion of the bill, reimbursing beneficiaries for out-of-pocket medical expenses that you paid to civilian providers based on the plan’s policies. All supplemental insurance policies have their own fine print, so you should read your travel insurance policy carefully to make sure you know what it will and will not cover.
You can discuss this further with the managed-care contractor for the Tricare region in which you live. If you contact your managed care contractor, you should also inquire about any emergency guidelines you need to know about while you are outside the U.S.
As your primary coverage while overseas will be the Tricare Standard portion of your Tricare for Life benefit, be prepared to pay up front for urgent or emergency care. You will then have to submit a claim for reimbursement when you return home. Make sure you save all medical bills and receipts to submit with your reimbursement claim. You would file claims through International SOS, the contractor for the Tricare Overseas Program.
Some general tips: Before your trip, make sure that the registry information on you and your wife in the Defense Enrollment Eligibility Reporting System database is accurate and up to date. DEERS is the Defense Department’s eligibility portal for Tricare; you can reach the DEERS main support office at toll-free 1-800-538-9552. Also, while you’re overseas, keep handy the phone number for the Tricare Area Office that covers Eurasia andAfrica. The number is 011-49-6302-67-6314.
We are planning a trip to Ireland. What if one of us needs to be medically evacuated back to the U.S. because of a long recovery or serious illness? Will Tricare for Life cover it?
Medicare does not operate outside the U.S. From the moment you leave U.S. waters or air space, your only coverage will be Tricare Standard until you return to U.S. soil. For that reason, while on your trip, it is essential that you save every scrap of medical bills, payment receipts, doctor’s statements, copies of prescriptions and receipts, and the like. You will need those documents to file a Tricare Standard claim for any medical services you receive while outside the U.S. Tricare Standard will process claims for those services just as it always does, making the same payments and charging you the same cost shares and deductibles as if you did not have Medicare for those services.
Medical evacuation via air ambulance is a covered benefit under Tricare Standard. If the air ambulance company requires guarantee of payment, it’s the responsibility of the beneficiary or his employer to provide the information. Once the medical evacuation is complete, the air ambulance company must send the bill directly to the beneficiary. The bill must name the beneficiary as the “bill to” patient name. The company can’t submit the bill to Tricare on behalf of the beneficiary. The beneficiary must file a claim for the bill with International SOS (the overseas Tricare contractor) for processing. Once the bill is processed, International SOS will send the payment to the beneficiary. Once the beneficiary has received the payment, it’s his responsibility to submit the payment to the air ambulance company to close out the claim.
How does a Tricare for Life beneficiary get reimbursed for hospital and doctor bills when traveling outside the continental U.S.?
From the moment you leave U.S. territory, you will have no coverage by the Medicare portion of Tricare for Life. Federal law does not allow Medicare to pay for foreign medical care. Your only coverage will be Tricare for any medical care received outside the US and its territories.
Thus, you must carefully save copies of all medical bills, receipts, doctors’ statements, prescriptions, and the like until you return home. You will need them at that time to file Tricare claims.
You have written that “under Tricare for Life, you must get all your civilian medical care from Medicare providers only.” That’s only if you expect Medicare to pay its portion under Tricare for Life, right? I live overseas and will enroll in both Medicare Part A and Part B when the time comes, precisely so that my current Tricare Standard coverage will continue, under the name Tricare for Life. Of course, Medicare will not pay for any care received outside the U.S., so I won’t expect any reimbursement from Medicare. However, I will still be covered, as I am now, by Tricare Standard, generally getting 80 percent of covered charges reimbursed by Tricare, with essentially the same deductibles and catastrophic cap I have now — right? Or am I confused?
Indeed, if a beneficiary wants Medicare to pay any part of the bill, he must get care from Medicare providers only. True, one who lives overseas — where Medicare coverage does not exist — is not required to use Medicare providers only for his care.
You are correct that, when you become legally entitled to free Medicare Part A (usually at age 65), federal law requires you to be enrolled also in Medicare Part B in order to retain your Tricare eligibility.
Retirees who live overseas have complained for many years about the requirement to be enrolled in, and pay a monthly premium for, Medicare Part B, which they cannot use. The issue has been raised to Congress many times, but Congress has never changed, or even debated changing, that law. My understanding is that the proposal has never made it out of committee.
Your claims must be filed with Tricare Standard, and they are subject to the usual $150 Tricare fiscal year deductible and your 25 percent cost share (for retirees and their family members) of the amount allowed on the claim. They must be processed as if you did not have Medicare. A suitable Tricare supplement may be a good idea for you.
Q. Am I covered by my Tricare for Life while traveling to England, and if so, at what percent?
From the moment you leave US waters or air space, your Medicare coverage ceases. Federal law does not allow Medicare to pay for any medical care you receive when outside the US and its possessions. Your only coverage will be Tricare Standard until you return to US soil.
For that reason, while on your trip, it is essential that you save every scrap of medical bills, payment receipts, doctor’s statements, copies of prescriptions and receipts, and the like. You will need those documents to file a Tricare Standard claim for any medical services you receive while outside the US.
Tricare Standard will process claims for those services just as it always does, making the same payments and charging you the same cost shares and deductibles as if you did not have Medicare for those services.
Q. I would like to take my daughter and granddaughter to Korea. I want to know if my granddaughter will be covered in Korea. Her dad is in the Army and she is in Tricare under him.
Please call the DEERS Support Office, toll-free, at 1-800-538-9552, to ensure that your granddaughter’s DEERS record is correct, up-to-date, and won’t expire before she returns home.
If she is enrolled in Tricare Standard — not Tricare Prime — she has coverage worldwide. Tricare Prime does not provide coverage overseas.
I suggest that you call your Regional Tricare Service Center to discuss the matter with that office.
If she receives foreign medical care, it is important that you save all medical documentation — copies of bills, receipts, prescriptions, doctor’s statements, clinical notes, and the like. You will need that information to file Tricare claims after she returns home. You do not have to provide translations or currency conversions. Tricare will do that.
Note that foreign providers are not likely to recognize U.S. health insurance of any kind. Most will expect payment “up front” when services are rendered.
If you or any member of your party is a Medicare beneficiary, please be aware that Medicare, by law, cannot pay for any foreign medical care. Medicare benefits are lost the moment a beneficiary departs US waters or air space.
Q. I understand that Tricare for Life members are covered only by Tricare Standard when traveling outside the U.S. Are any short-term Tricare supplemental policies available to cover the difference between Tricare’s payments and total charges while traveling?
Yours is a question frequently asked. Unfortunately, I know of no such short-term supplemental policy.
I have decried the absence of such policies for years in this column. Their continued absence from the offerings of all insurers must indicate some universal obstacle of which I’m unaware — I doubt the insurance industry would otherwise ignore such a potential money-maker.
Short of buying a “regular” Tricare supplement, your only protection against costs beyond the amount Tricare pays is your $3,000 catastrophic cap.
If you consider buying a regular supplement, read the fine print carefully before you buy to be certain the supplement will meet all your needs outside the U.S.