An official website of the United States government
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

News | July 18, 2024

Does TRICARE For Life Work With Other Insurance? Here’s What You Should Know

By TRICARE Communications

Do you have TRICARE For Life? If so, you may know that Medicare and TRICARE For Life work together to minimize your out-of-pocket expenses. After Medicare processes your claim, it forwards the claim to TRICARE For Life for processing. This eliminates the need for you to file a claim. But if you also have other health insurance, also known as “OHI,” you may have to submit a claim in order to receive reimbursement under TRICARE.

OHI is any health insurance you have in addition to TRICARE. Medigap plans and current or former employer group health plan coverage are examples of OHI.

“If you have Medicare, TRICARE For Life, and OHI, each type of coverage is called a ‘payer,’” said Anne Breslin, TRICARE For Life program manager at the Defense Health Agency. “When there’s more than one payer, the order of payment is called ‘coordination of benefits.’ Coordination of benefits rules determine who pays first.”

It’s good to understand how TFL works with OHI. This helps ensure that your claims are paid correctly. Keep reading to learn more.

Reporting your OHI

Medicare doesn’t automatically know if you have OHI. However, insurers must notify Medicare when they’re responsible for paying first on your medical claims.

If you have OHI, you need to tell TRICARE. You can do this by submitting an OHI questionnaire.

  • If you live in the United States or U.S. territories, fill out the TRICARE For Life OHI Questionnaire. Submit the form to the TFL contractor, Wisconsin Physicians Service.
  • If you live outside the U.S. and U.S. territories, fill out the Overseas OHI Questionnaire and send it to the TRICARE Overseas contractor, International SOS. Or you can update your OHI information in your TOP Beneficiary Secure Claims Portal.

In some cases, your health care provider, employer, or insurer may ask questions about your current coverage so they can report that information to Medicare.

Using OHI with TRICARE and Medicare

“How Medicare coordinates claims with your OHI plan depends on whether you’re 65 or older, if you’re working or retired, and the number of people employed by the employer providing the group health plan coverage,” said Breslin. “Regardless of which of these factors apply to you, TRICARE For Life pays last, after Medicare and your OHI plan.”

Medicare pays first and OHI pays second if one of these scenarios applies to you:

  1. You have retiree health coverage (insurance from your or your spouse’s former employment).
  2. You’re 65 or older, you have group health plan coverage based on your or your spouse’s current employment, and the employer has fewer than 20 employees.
  3. You’re under 65 and have a disability, you have group health plan coverage based on your or a family member’s current employment, and the employer has fewer than 100 employees.

However, your group health plan pays first if one of these scenarios applies to you:

  1. You’re 65 or older, you have group health plan coverage based on your or your spouse’s current employment, and the employer has 20 or more employees.
  2. You’re under age 65 and have a disability, you have group health plan coverage based on your or a family member’s current employment, and the employer has 100 or more employees.

Lastly, if you have group health plan coverage based on your or a family member’s employment or former employment, and you’re eligible for Medicare because of end-stage renal disease, your group health plan will pay first for the first 30 months after you become eligible to enroll in Medicare. Medicare pays first after this 30-month period.

How to file claims

When your OHI is the second payer, and there’s a remaining patient liability, you must submit a claim for TRICARE to reimburse you for TRICARE’s portion of your claim.

In the U.S. and U.S. Territories: After your OHI and Medicare have processed a claim, you need to submit a paper claim to Wisconsin Physicians Service, with the following supporting documentation:

  • An itemized provider bill
  • Your Medicare Summary Notice showing what Medicare paid
  • The explanation of benefits from your OHI plan showing what it paid

WPS will process the claim and pay you the portion that TFL covers. You must submit your claim within one year of the date you got care.

If you have any questions about filing claims when you have OHI, contact WPS. The WPS website has instructions and forms for filing secondary claims, FAQs, and more.

Overseas: Medicare doesn’t pay for care you receive overseas, as explained in the TRICARE For Life Handbook. (This doesn’t include U.S. territories.) If you get care overseas with TFL and OHI, you’ll need to file a claim with the TRICARE Overseas contractor to get reimbursed.

Learn more about filing claims overseas and supporting documentation needed for overseas claims.

Learn more about TFL

Looking for more information about TFL? Check out these resources:

Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.
 
Service member smiles with arms crossed in an office.

Explore Available Counseling and Mental Health S...

News
Sep. 10, 2025

Are you a service member, family member, or survivor? Your TRICARE benefit covers a variety of mental health...
Read More
Young woman sitting on couch speaking on cell phone

Live in the West Region? Learn if You Need To Ta...

News
Sep. 09, 2025

Are you a TRICARE Prime beneficiary living in the West Region? Are you currently using a referral to get...
Read More
Two uniformed service members stand in military pharmacy and funnel prescriptions into a bottle.

Q&A: TRICARE For Life Coverage of Weight Loss Me...

News
Sep. 08, 2025

The Defense Health Agency recently announced it will implement existing regulatory controls regarding TRICARE...
Read More
Provider wearing lab coat and stethoscope taking patient's blood pressure. Text reads: "Patients needed on Sept. 26 for a focus group discussion about hypertension (high blood pressure). Sign up deadline is Sept. 19. Learn if you qualify." TRICARE logo

Help Shape Clinical Practice Guidelines in Joint...

News
Sep. 04, 2025

The Department of Defense and Veterans Health Administration have partnered together and are inviting patients...
Read More
Service member smiles while posing in front of a building

Q&A: Understanding Eligibility and Coverage With...

News
Aug. 28, 2025

If you live far from a military hospital or clinic, TRICARE Prime Remote could be the right TRICARE health...
Read More
Father and son hold hands while walking down a street

Unlock Your Health by Understanding the TRICARE ...

News
Aug. 26, 2025

Do you have TRICARE Prime? If so, you likely get most of your routine health care from your primary care...
Read More
Image of woman sitting on sofa on laptop. Text reads: "Participants needed for virtual tricare.mil usability study. Learn if you qualify." TRICARE logo

Share Your Thoughts on Tricare.mil in Upcoming U...

News
Aug. 22, 2025

Are you interested in shaping the future of TRICARE’s web presence? The Defense Health Agency Usability Lab is...
Read More
Smiling woman holds a baby.

How TRICARE Covers Breastfeeding Supplies and Se...

News
Aug. 21, 2025

Are you pregnant or did you recently have a baby? TRICARE covers certain breast pumps and supplies and...
Read More

Sept. 10, 2025

Explore Available Counseling and Mental Health Services

Are you a service member, family member, or survivor? Your TRICARE benefit covers a variety of mental health services. But did you know there are other counseling services available to you? This article explores what services you can access if you need support.

Sept. 9, 2025

Live in the West Region? Learn if You Need To Take Action on Your Referrals Before Oct. 1

Are you a TRICARE Prime beneficiary living in the West Region? Are you currently using a referral to get specialty care? If you used the West Region referral approval waiver to see a specialist between Jan. 1 and June 30, 2025 and need to continue seeing that specialist, you’ll need to get a new referral to a network specialist before Oct. 1, 2025. If you’re still using a valid referral issued by a previous contractor before Jan. 1, 2025, you also need to get a new referral for any care received starting Oct. 1.

Sept. 8, 2025

Q&A: TRICARE For Life Coverage of Weight Loss Medications

The Defense Health Agency recently announced it will implement existing regulatory controls regarding TRICARE coverage of weight loss medications, including Glucagon-Like Peptide 1 (GLP-1) drugs, to ensure prescription processing aligns with federal coverage requirements.

Sept. 4, 2025

Help Shape Clinical Practice Guidelines in Joint DOD, VA Patient Focus Groups: Hypertension on Sept. 26

The Department of Defense and Veterans Health Administration have partnered together and are inviting patients to share their experiences managing hypertension, or high blood pressure. This initiative is part of a virtual focus group on Friday, Sept. 26 at noon ET. It will help shape clinical practice guidelines for treating hypertension across military and veteran communities.

Aug. 28, 2025

Q&A: Understanding Eligibility and Coverage With TRICARE Prime Remote

If you live far from a military hospital or clinic, TRICARE Prime Remote could be the right TRICARE health plan for you. While TRICARE Prime is only available to eligible beneficiaries in Prime Service Areas (designated regions that have proximity to military hospitals or clinics), TPR extends coverage beyond PSAs. This plan helps active duty service members and their family members get care when they live or work in areas that are remote from military hospitals or clinics.

Aug. 26, 2025

Unlock Your Health by Understanding the TRICARE Prime Referral Process

Do you have TRICARE Prime? If so, you likely get most of your routine health care from your primary care manager. But sometimes, you may need specialty care that your PCM can’t provide. This is when your PCM will give you a referral. In this article, you’ll learn about the TRICARE Prime referral process. We’ll highlight what’s new—and easier—for you and your family members if you’re moving this year.

Aug. 22, 2025

Share Your Thoughts on Tricare.mil in Upcoming Usability Study

Are you interested in shaping the future of TRICARE’s web presence? The Defense Health Agency Usability Lab is looking for participants for a tricare.mil usability study. The DHA Usability Lab will hold several studies to get feedback on the website.

Aug. 21, 2025

How TRICARE Covers Breastfeeding Supplies and Services

Are you pregnant or did you recently have a baby? TRICARE covers certain breast pumps and supplies and breastfeeding counseling at no cost for new mothers.

Aug. 19, 2025

TRICARE Medical vs. Dental Coverage: Understanding Key Differences

When you need care for your mouth, jaw, or teeth, you may have questions about whether you should use your TRICARE medical or dental plan. Knowing when to use your medical or dental coverage helps avoid unnecessary costs or delays in care.

Aug. 14, 2025

Medicare and TRICARE For Life: Finding Providers

If you have TRICARE For Life, you’ll get health care from Medicare providers. Here’s what you need to know about finding different types of Medicare providers.