Veteran’s Community – Family Corner
Many TRICARE beneficiaries also carry other health insurance—through an employer, a spouse’s employer, or a private policy. Understanding how the two plans coordinate is essential so claims are paid correctly and you avoid unexpected bills.
TRICARE as Wraparound Coverage
When you have additional coverage, TRICARE functions as wraparound (secondary) coverage. That means:
- Your Other Health Insurance (OHI) pays first.
- You or your provider should file a claim with TRICARE only after the OHI has processed the claim and issued an Explanation of Benefits (EOB).
- TRICARE then considers payment of any remaining allowable costs according to TRICARE rules.
Important: You must follow the rules of your other health insurance. If the OHI denies a claim because you failed to meet its requirements (for example, using an out-of-network provider when the plan required in-network care, or skipping prior authorization), TRICARE may also refuse to pay.
Exceptions – When TRICARE Pays First
There are a few situations in which the normal “TRICARE pays last” rule does not apply. File claims with TRICARE first if your other coverage is one of the following:
- Medicaid
- A TRICARE supplemental plan
- State victims-of-crime compensation programs
- Other federal government programs specifically identified by the Defense Health Agency
What Happens If You Lose Your Other Health Insurance
Losing OHI is a Qualifying Life Event. When that happens:
- TRICARE automatically becomes the primary payer.
- Notify your TRICARE contractor right away that your OHI status has changed.
- You and any eligible family members have 90 days from the date you lost the other coverage to change your TRICARE health plan if you wish.
Prompt notification helps ensure claims are processed under the correct primary-payer rules and prevents delays or denials.
Practical Tips
- Keep copies of all EOBs from your other insurance.
- Confirm with both plans whether a service requires prior authorization.
- Update your OHI information in the Defense Enrollment Eligibility Reporting System (DEERS) and with your regional TRICARE contractor whenever coverage is added or lost.
- If you are unsure which plan pays first, contact your TRICARE contractor or the Beneficiary Counseling and Assistance Coordinator (BCAC) at your nearest military treatment facility.
Coordinating benefits correctly keeps out-of-pocket costs lower and reduces administrative headaches for both you and your providers. When in doubt, call your TRICARE regional contractor—they can walk you through the exact steps for your situation.
Here are key official contact phone numbers especially useful for the topics in this article (TRICARE coordination with Other Health Insurance/OHI, claims, eligibility updates, and related military/veteran benefits).
TRICARE Regional Contractors (for claims, enrollment, OHI status changes, authorizations)
- TRICARE West Region (TriWest Healthcare Alliance) — covers Texas (including the Killeen/Fort Cavazos/Copperas Cove area): 888-TRIWEST (888-874-9378)
Hours are generally 8 a.m.–6 p.m. in your time zone, Monday–Friday (excluding federal holidays). Notify them promptly if you lose OHI so TRICARE becomes primary. - TRICARE East Region (Humana Military): 800-444-5445
Confirm your exact region/ZIP on tricare.mil if needed, as boundaries can have limited exceptions.
DEERS / Eligibility Updates
- DMDC/DEERS Support Office: 800-538-9552 (TTY/TDD: 866-363-2883)
Use this to update address, contact info, or eligibility records (critical when OHI status changes). You can also update many details online via milConnect.
Pharmacy
- TRICARE Pharmacy Program (Express Scripts): 877-363-1303 (stateside)
Other Important TRICARE / Military Health Numbers
- TRICARE For Life (WPS): 866-773-0404 (TDD: 866-773-0405)
- MHS Nurse Advice Line (24/7 registered nurse advice): 800-TRICARE (800-874-2273), option 1 (U.S.)
- Military OneSource (general support, counseling, resources): 800-342-9647
- Beneficiary Counseling and Assistance Coordinators (BCACs): Located at military treatment facilities (e.g., Carl R. Darnall Army Medical Center at Fort Cavazos). Search by location on tricare.mil for the local number—they help with complex claims and benefit questions.
Key VA Numbers (for veterans)
- MyVA411 main information line (24/7 single access point for benefits, health care, etc.): 1-800-MyVA411 (1-800-698-2411)
- VA Benefits Hotline: 800-827-1000
- Veterans Crisis Line: 988 (then press 1) or 800-273-8255 (press 1); text 838255
Tips :
When you lose OHI or need to file after the other plan processes a claim, start with your regional TRICARE contractor (West number above for most of Texas). Always keep EOBs and update DEERS + the contractor. For local help with coordination-of-benefits issues, contact the BCAC at your nearest military hospital/clinic.
Official sources: tricare.mil/ContactUs and va.gov. Numbers and hours can change, so verify on the official sites or the Call Us Wizard on tricare.mil if possible.
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