TRICARE Supplement Insurance
Healthy Savings On Health Care: TRICARE Supplement Insurance Coverage
We all know how much it costs to get medical care. The MBA-sponsored TRICARE Supplement is designed to help minimize and even eliminate the costs your TRICARE health plan doesn't cover.
The MBA TRICARE Supplement Insurance Plan helps provide reimbursement of eligible out-of-pocket medical expenses for insured MBA members and their families who are covered by TRICARE (Standard, Extra or Prime).
Three TRICARE Options
TRICARE Prime is a voluntary "HMO-type" supplement plan that emphasizes preventive care. All active duty service members who elect coverage are automatically enrolled in Prime. If you choose this option, you and your family will enroll for a year at a time, and will receive your care from a network of civilian and military providers.
TRICARE Extra supplements a Preferred Provider Organization (PPO) plan. With this option, you can choose to use a network of civilian doctors and military providers and participate in cost sharing.
This supplements the standard TRICARE program. TRICARE Standard pays a share of the cost of covered health care services that you obtain from a non-network civilian health care provider. After the TRICARE deductible has been met, the TRICARE Standard will cost-share 20% of the TRICARE allowable charge for outpatient services and supplies for active duty families and 25% of the allowable charge for all others.
Who Is Eligible To Enroll?
To be eligible, persons must be under age 65 on their coverage effective date and authorized to enroll in or use TRICARE for medical care coverage. Unmarried dependent children from birth to age 21, or 23 if a full-time student, are also eligible. A child who is covered by the TRICARE Young Adult Program and is under age 26 may also enroll.
What would be Covered?
The Supplement Plan pays eligible out-of-pocket expenses, after any applicable deductible, as follows:
- 100% of co-pays and Cost-shares for TRICARE (Standard, Extra, Prime)
- 100% of covered Excess Charges above the TRICARE Standard Allowable Amount**
- 100% of the TRICARE (Standard, Extra) outpatient deductible, if elected
- 100% of Cost-shares and covered Excess Charges for Prime Point of Service
- 100% of the daily subsistence fee the insured must pay in a government facility
- The daily inpatient charges from the first day.
What Is Not Covered?
MBA TRICARE Supplements are underwritten by: Hartford Life Insurance Company in ME, MD, MN and MT and Hartford Life and Accident Insurance Company in all other states. Home offices of both companies is Simsbury, CT 06089.
- Charges incurred for services which are not covered or excluded by TRICARE
- Charges for which the insured is not legally obligated to pay, up to the legal limit
- Charges incurred prior to the individual's effective date of coverage under the Plan
- Charges incurred for pre-existing conditions, except as outlined in the Plan, up to the legal limit
- Enrollment fees under TRICARE Prime
- Deductible amounts for the TRICARE Prime Point of Service option
- Any TRICARE (Standard, Extra) deductible amount unless you have selected the Outpatient Deductible Reimbursement Option
- Charges for outpatient services, as defined under TRICARE, if the individual has not enrolled for outpatient coverage under this Plan.
** Note that doctor and medical providers are not to exceed the TRICARE 115% legal limit.
(This website explains the general purpose of the insurance described, but in no way changes or affects Master Policies AGP-5859 and AGP-5860 as actually issued. In the event of a discrepancy between this brochure and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident insurance Company and Hartford Life Insurance Company detail exclusions, limitarions, and terms under which policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.)
For additional information (including costs, limitations, exclusions, reduction in benefits and terms of coverage) please click the following link Enrollment Form
Form SRP-1269 (HLA)
Form SRP-1269 (HL)