Welcome to TRICARE Supplements

Did you know… Military retirees that have launched their 2nd career with your organization already have a pre-paid health plan?
It is called TRICARE. The most common oversight by employers is not recognizing that TRICARE can be used as their primary coverage, rather than your employer sponsored health plan. Allowing TRICARE eligibles to opt out of your company’s plan and utilize their military benefit would create a potential cost reduction
EXAMPLE: 500 (eligible) x $4150* = $2,075,000 per year

*Kaiser/HRET survey of employer sponsored health benefits, 2010

How It Works

Summary of Plan Benefits

Here’s How The Comprehensive Tricare Supplement Works To Pay After Tricare Has Paid

Care Required	TRICARE Standard / Extra Pays	Your TRICARE Extra/Standard Supplement Pays	TRICARE Prime or Point-Of-Service (POS Pays)	After TRICARE Prime / POS Pays, The Supplement Pays
INPATIENT FACILITY SERVICE in civilian hospitals for RETIREES and their dependent family members (room, board, supplies and staff services billed by the hospital).	The TRICARE Standard /DRG allowed amount (contracted rate for TRICARE Extra minus your cost share).	The lesser of $635/day or 25% of the billed amount, not to exceed the TRICARE Standard DRG amount (lesser of $250/day or 20% cost share of the contracted rate for TRICARE Extra) PLUS 100% of applicable excess charges.	PRIME – All but the Prime copayments. POS – 50% of the TRICARE allowed amount after the deductible has been met.	All Prime copayments. The 50% POS cost share half the POS deductible* ($ 150 per person or $300 per family) PLUS 100% of applicable excess charges.
INPATIENT PROFESSIONAL SERVICES in civilian hospitals for RETIREES and dependent family members ( doctors, other inpatient services not billed by the hospital)	75% of the TRICARE Standard allowed amount (80% for TRICARE Extra for doctors and other professional services.)	Your 20% Extra or 25% Standard cost share deductible* ($150 per person or $300 per family) PLUS 100% of charges in excess of the TRICARE Standard allowed amount if applicable.	PRIME – All but the Prime copayments. POS – 50% of the TRICARE allowed amount after the deductible has been met.	All Prime copayments. The 50% POS cost share half the POS deductible* ($ 150 per person or $300 per family) PLUS 100% of applicable excess charges.
Inpatient care in military hospitals	All but the daily subsistence fee.	The daily subsistence fee.	The daily subsistence fee.	The daily subsistence fee.
OUTPATIENT CARE for RETIREES and their dependent family members (office visits, clinics, lab, etc).	75% of the TRICARE Standard allowed amount (80% for TRICARE Extra) after you pay the TRICARE Outpatient Deductible.	Your 20% Extra or 25% Standard cost share deductible* ($150 per person or $300 per family) PLUS 100% of charges in excess of the TRICARE Standard allowed amount if applicable.	PRIME – All but the Prime copayments. POS – 50% of the TRICARE allowed amount after the deductible has been met.	All Prime copayments. The 50% POS cost share half the POS deductible* ($ 150 per person or $300 per family) PLUS 100% of applicable excess charges.
PRESCRIPTION DRUGS (civilian network up to a 30-day supply or TRICARE Mail Order Pharmacy up to a 90-day supply).	All but the $3 generic, $9 brand name or $22 non- formulary	All copayments.	PRIME – All but the Prime copayments. POS – 50% of the TRICARE allowed amount after the deductible has been met.	All copayments The 50% POS cost share half the POS deductible* ($ 150 per person or $300 per family).
PRESCRIPTION DRUGS (civilian non network Pharmacy up to a 30-day supply).	All but the deductible and $9/20% brand name or $22/20% non-formulary copayment, whichever is greater.	$9/20% or $22/20% Standard cost share PLUS the TRICARE deductible* ($150 per person or $300 per family).	Not Applicable.	The 50% POS cost share half the POS deductible* ($ 150 per person or $300 per family).

Reimbursement toward the fiscal year TRICARE Standard/Extra Outpatient Deductible the Comprehensive Plan is made only if the deductible is incurred after the effective date of coverage.

PORTABILITY

The TRICARE Supplement plan is portable. This means that when employment ends for any reason, you can take the coverage with you by paying the full monthly premium directly to ASI.

Eligibility

TRICARE

TRICARE eligible beneficiaries must be enrolled in the Defense Enrollment Eligibility Reporting System (DEERS). DEERS is a computerized database of beneficiaries, worldwide, who are entitled to TRICARE benefits. The following is a list of some of these TRICARE eligible beneficiaries:

Military retirees who are entitled to retiree, retainer or equivalent pay
Spouses, surviving spouses and some former spouses of military retirees, active duty service members and TRICARE eligible reservists
Retired reservists (usually eligible at age 60 after 20 creditable year of military service) and their eligible family members.
And unmarried dependent children up to age 21 or 23 if full time student

Military retirees and spouses must be under age 65, unless ineligible for Medicare. Unmarried dependent children must be under age 21 (or age 23 if full time student). Eligibility may extend past age 21 or 23 for some mentally or physically incapacitated children. (Contact your TRICARE Service Center for further eligibility requirements).

Tricare Benefit Options

TRICARE is the military healthcare system for active duty and retired members of uniformed services and their eligible family members. TRICARE uses a combination of military hospitals and clinics and civilian professionals to treat uniformed service member, retirees and their eligible family members. TRICARE includes three healthcare insurance options, namely TRICARE Standard, TRICARE Extra and TRICARE Prime.

Prescription Drug Benefit
TRICARE implemented a fully integrated retail pharmacy program managed by Express Scripts, Inc. (ESI). Express Scripts manages both the TRICARE Mail Order and retail pharmacy contracts. Express Scripts Provides the customer service contact and processes the prescription drug claims

Where to get Prescriptions Filled
Eligible beneficiaries still have four sources to fill their prescriptions. They may fill prescriptions at:

Military treatment facility (MTF) pharmacies
The TRICARE Mail order Pharmacy (TMOP)

Civilian retail network pharmacies, and
Civilian non- network pharmacies

The TRICARE Supplement Plan
The TRICARE Supplement Plan is offered to TRICARE eligible employees who are insured by TRICARE Standard/Extra or are enrolled in Prime.

Plan Features of the TRICARE Supplement:

No pre-existing condition exclusion
No plan deductibles
Protection from excess charges
Guaranteed acceptance in the Supplement Plan
Freedom of choice – Employees and their families may utilize any TRICARE authorized civilian doctor or specialist
Comprehensive coverage
Prompt processing of claims
Portability – Employees may choose to continue Supplement Plan coverage if employment ends for any reason
No claim forms required – but if you choose to use claim forms, they are available from the ASI web site at www.asicorptricaresupp.com or by calling ASI’s toll free customer service number
Toll-free fax number for claim submission– 1-800-310-5514
No separate pre-certification or pre-authorization requirement
Virtually 100% coverage between TRICARE and the TRICARE Supplement for most eligible charges.

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Keep in Touch!
We will be glad to assist you if you have any questions!
Telephone: 1-800-899-1900
Email: info@tricareinsurance.com
Mail:TRICARE Supplements
1620 Main Street Building 5,
Sarasota, FL 34236