Tricare Military Insurance: 6 Surprising Facts New Spouses Desperately Need

by Heather on August 17, 2015

"Tricare Military Insurance: 6 Surprising Facts New Spouses Desperately Need" by Heather of Happyfitnavywife.com | Glad to know these!

Tricare Military Insurance: 6 Surprising Facts New Spouses Desperately Need

One challenge of becoming a new spouse is that your Tricare military insurance can be somewhat of a mystery. It took me longer than I’d like to admit to learn some really helpful things about the way Tricare works.

I’ve decided to share a few surprising facts about Tricare Military Insurance that will likely come in handy for you, especially if you’re a new spouse. Finally learning these has saved me money, time, agony, and my mental sanity… ha!

  1. Tricare consists of three separate regions: North, South and West. Each is run by a different company. You have to re-enroll if you want to stay Prime when you move because the companies do not share info. And yes, you also have to start over and wait for referrals from your new doctor after you PCS.
  2. Your military ID is your insurance ID card. This can be confusing at first when a provider asks for your insurance card. And, since dependent cards don’t have your sponsor’s social security number anymore (your sponsor is your spouse), you’ll need to know their social too.  Three cheers to Tricare for not giving us an extra card to carry around and keep track of!
  3. Tricare military insurance does not cover dental. They contract that out with MetLife and you have to enroll separately, but it’s great coverage. I learned this the hard way after I first got married when I went to an appointment that was not covered. Ahhhh! Not fun to pay out of pocket. Make sure to enroll here.
  4. You can call and talk to a Tricare Representative… and they are very nice! I don’t know why I got it in my head at first that it was drudgery to call. Not like it’s a blast to work out insurance claims. But the reps at Tricare are helpful, knowledgeable, and friendly. Score. You can call ask about your coverage, to get information on claims, or whatever issue you need help with. Kind of shocking!
  5. You can have a three-way phone call with Tricare and your provider’s business office to straighten out your claims. I learned this while trying to straighten out a recent fertility bill. I was trying to communicate back and forth between my doctor’s office and Tricare, when the rep suggested we do a three-way call. It worked out well and we all got on the same page. Sometimes it’s necessary to take out the middle man (me and you) and let the two companies talk to each other directly.
  6. They’ll refer you out to (and cover) physical therapy but they won’t to a chiropractor. I discovered this due to some back issues I had when hubby and i were dating. I went to a chiropractor regularly, and after we got married, I spent the first couple of years just paying out of pocket for a chiropractor like I had before. When we PCS’d to Washington and I saw a new provider, she mentioned that she could refer me to physical therapy. I was all for trying it, especially since it was covered! Physical therapy worked really well for me and saved me money. So, if some treatment you need isn’t approved, be sure to ask if there is an alternate form of care that Tricare will cover.

Tricare Military Insurance

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{ 16 comments… read them below or add one }

1 Kim R at 1200 Miles Away August 18, 2015 at 2:48 pm

These are great tips! I know there is so much mystery with Tricare, even with spouses who have been in for many years. I would add, if you are travelling outside your region, you can still get help (ER or Urgent Care). Just report it to your region (not the region you are travelling to).

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2 Heather August 20, 2015 at 2:34 pm

Thanks Kim- good point, that’s important to know that if you’re on Prime you have to report ER trips to your own region. That can be confusing!

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3 Julie August 21, 2015 at 11:16 am

This is great! Tricare is so confusing sometimes. Hard to get used to it.

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4 Heather August 21, 2015 at 3:41 pm

Thanks Julie! And things change so fast so I am always playing catch up!

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5 Erin August 21, 2015 at 12:15 pm

It is also worth noting that in some areas of the country you are also eligible for US Family Health Plan. This is a partnership between TRICARE and local Hospital Systems. For instance in New England it is with Brighton Marine Health (BTW- I had a breast reduction TOTALLY covered with no supporting documents in this region!!)
In the DC area it is with Johns Hopkins and you get all the great JH specialists too. US Family will also cover traditional Chiropractic Care. It a great option if they have it in your region!

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6 Heather August 21, 2015 at 3:43 pm

Wow that is AWESOME! I had no idea about that way to go. Can you get to that through the Tricare website or is that totally separate? I’ll take note of that!

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7 Keating August 21, 2015 at 12:41 pm

Dental through MetLife is AMAZING. I had to get a couple thousand dollars worth of work done in order for overseas screening to sign off on my PCS paperwork and through MetLife, I only paid about $300 total. That’s for two extractions, a cleaning, and about six or seven fillings. The extractions alone would have been about $300+ each. I was so thankful for MetLife!

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8 Heather August 21, 2015 at 3:44 pm

Wow that is great news! Yes I love their coverage too, esp because I have so many cavities… =(

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9 Jenn August 21, 2015 at 1:48 pm

Your ID card is ONLY your Tricare Medical card IF you’re active duty. When we were just M-Day National Guard, before my husband was put on active duty orders, we DID have a print out with our information that we laminated and kept in our wallets, like a traditional insurance card.

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10 Heather August 21, 2015 at 3:45 pm

Thanks Jenn- that’s good to know. So you mean if your spouse is active duty then? I’m a dependent and my ID is my insurance ID, but my hubby is active duty. Good to know for reservists– thanks for pointing that out!

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11 Julie August 23, 2015 at 5:21 pm

Sponsor can get an “eligibility” letter (stating you are covered by Tricare, either region) for all family members through his/her MilConnect website.

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12 Heather August 24, 2015 at 9:09 pm

Thanks Julie! In what way can you use the eligibility letter?

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13 Terri March 1, 2016 at 4:03 pm

Tricare does not completely cover therapy. You have to pay a copay for every visit.

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14 Heather March 25, 2016 at 11:19 am

Ok thanks. I don’t recall having to pay until I switched to Standard but I did my PT several years ago, so things must have changed. Or I’m forgetting, which is highly possible! =)

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15 Jessica July 7, 2016 at 10:35 pm

I feel like not enough people know this and its touchy but this is a good forum… If the spouse of the active duty member is listed on their SGLI and the wife delivers a baby/still born (i don’t know the technical terms) older than 20 weeks that dies they are entitled to a life insurance benefit of 10K for the death of a child. If it happened last week or 10 years ago you are covered. Tell your OBGYN if you are in a military town. I told mine and she had no idea about it and said it happens enough that she was glad I told her about it.

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16 Heather July 8, 2016 at 11:10 pm

Thanks Jessica– I actually just heard about that last week. That’s an amazing piece of info to know, even though sad to think about. Thank you for sharing!

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