Do you have TRICARE For Life (TFL)? Are you living, moving, or planning to travel overseas? It’s important to know how your TFL coverage works outside of the US and US territories.
“TRICARE For Life works differently overseas,” said Michael Griffin, a program analyst with the TRICARE Overseas Program Office at the Defense Health Agency. “Knowing your options for getting care and how to file claims will help you avoid unexpected costs.”
Keep reading for an overview of TFL, how to get care overseas, and more.
TFL is available to military retirees and their eligible dependents who are eligible for TRICARE and have Medicare Part A and Part B. This is regardless of your age or where you live. TFL is Medicare wraparound coverage. This means that if both Medicare and TRICARE cover a health care service, TRICARE pays last.
Medicare provides coverage in the United States and US territories. It also covers health care services you get on ships in US territorial waters.
But Medicare doesn’t provide coverage in any other overseas locations. This means that TRICARE is the primary payer for TRICARE covered services you receive overseas, unless you have other health insurance (OHI). If you have OHI, that plan always pays first.
All TFL beneficiaries are subject to the TRICARE catastrophic cap, deductibles, and cost-shares. Pre-authorization may be required for some care. Use the TRICARE Compare Cost Tool to find the costs associated with TFL stateside and overseas.
You have options for where you get care overseas. You can get care at military hospitals and clinics, if space is available. You may also get care from civilian providers, as described in the TRICARE For Life Handbook. You can use the Overseas Provider Directory to find an International SOS network provider near you. International SOS is the TRICARE Overseas Program administrator. If you see a civilian provider, be prepared to pay up front. Be sure to ask the provider for an itemized bill and be sure to keep your receipt as proof of payment. If you’re traveling overseas, you may want to consider buying travel insurance if you don’t want to pay up front for health care.
If you live in or travel to the Philippines, you must get care from a Preferred Provider or Certified Provider. If you need to get emergency care in the Philippines, go to the nearest emergency facility. Contact Global 24 Network Services before leaving the facility, preferably within 24 hours or the next business day, to coordinate continued care. Global 24 Network Services is a subcontractor of International SOS.
After you pay for care, you can file a claim with International SOS for reimbursement. You must submit proof of payment with all claims for care you receive overseas. Additionally, you must file claims with the claims processor for the overseas areas where you got care. Remember to file within three years of either the date of service or the date of inpatient discharge. Contact your TRICARE Overseas Program Regional Call Center and choose option 2 for claims assistance.
There may be no limit on the amount TRICARE nonparticipating, non-network providers charge you overseas. Keep in mind, you’re responsible for paying your deductible, cost-shares, and any amount that exceeds the TRICARE-allowable charge.
TFL makes it easy to get your prescriptions overseas. You can fill prescriptions at military pharmacies or through TRICARE Pharmacy Home Delivery, where available. Use the Find a Military Hospital or Clinic tool to find nearby military pharmacies.
Non-network overseas pharmacies can also fill your prescriptions. In this case, you’ll pay the full cost up front and file a claim with International SOS for reimbursement. Be sure to submit proof of payment with all overseas pharmacy claims. This includes an itemized bill or invoice.
No matter where you live or travel, TRICARE For Life has you covered. Check out the TRICARE For Life Handbook and the TRICARE For Life Cost Matrix to learn more.
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