DEDUCTABLE: The amount you pay before your TRICARE coverage starts to pay. Until you meet the maximum of your deductible, you pay 100% of your medical bill. For retirees (who almost all fall under Group A) deductibles for 2023 are $351.96 per individual and $703.92 per family. Deductibles are annual, thus they start all over every January 1st.
CO-PAY: Once you meet the initial deductible as described above, TRICARE begins paying 75% of your medical bills. Co-pay is the 25% TRICARE does not pay. You pay that co-pay of 25%. This continues throughout the calendar year until you reach the Catastrophic Cap.
CATASTROPHIC CAP: Once your deductible and co-pays equal, or exceed, the catastrophic cap amount, then you pay nothing! TRICARE pays if all within that year. The catastrophic cap for retirees under TRICARE For Life is $3,000
And again as a reminder: When January 1st rolls around, it all starts over for that next year
TRICARE Costs and Fees 2023: https://www.tricare.mil/-/media/Files/TRICARE/Publications/Misc/Costs_Sheet_2023.pdf
Knowing Your 2023 TRICARE Plan’s Catastrophic Cap: https://newsroom.tricare.mil/Articles/Article/3265784/start-2023-knowing-your-tricare-plans-catastrophic-cap
EOB - Explanation Of Benefits: A TRICARE explanation of benefits (EOB) is not a bill. It's an itemized statement that shows what action TRICARE has taken on your claims. You may receive a monthly EOB statement detailing all the claims you had in the past month. You should keep your EOB statements with your health insurance records. Read more at https://www.tricare.mil/PatientResources/GoPaperless/EOBOnline
After a divorce, unremarried former spouses may be eligible for TRICARE coverage if falling under one of these two rules:
To learn more about Former Spouses go to the TRICARE Former Spouses website at https://tricare.mil/Plans/Eligibility/FormerSpouses
By TRICARE Communications NEWS |Sep 20, 2022
https://newsroom.tricare.mil/Articles/Article/3163752/how-divorce-impacts-your-tricare-benefits
FALLS CHURCH, Va. – The divorce process can create intense emotions. You might feel frustrated or confused during this time. Thinking about your TRICARE benefits may be the last thought on your mind. However, it’s something you must consider. “TRICARE won’t pay for services or supplies provided to anyone who isn’t eligible for TRICARE, so it’s important you understand how your TRICARE coverage may change for you, your children, and your ex-spouse,” said Shane Pham, TRICARE policy and program analyst at the Defense Health Agency. “If a former spouse or a stepchild who wasn’t adopted loses eligibility in a divorce and continues to get care, TRICARE can recoup those payments which adds an extra layer of difficulty during an already challenging time.” Read Q&A to learn more about how divorce affects your TRICARE health benefits at https://newsroom.tricare.mil/Articles/Article/3163752/how-divorce-impacts-your-tricare-benefits
July 18, 2024
World-class Hospitals and University Medical Centers in Korea included in the TRICARE network with International Service Centers who file claims directly to TRICARE. TRICARE patients pay the 25%, and the Service Centers do the rest.
The Poppin' Smoke travel blog expert Stephanie has a great writeup on using TRICARE while traveling overseas, which is the same good advise for those living overseas such as in Korea, like us. Some of the topics they cover are listed below. Check out the page at https://www.poppinsmoke.com/tricare-coverage-while-traveling-overseas.
Dental services are limited at Military Facilities in Korea, almost almost non-existent for retirees. The military facilities are just not manned to handle it, so they don't offer the services.
FEDVIP Dental is a voluntary (you pay for) dental insurance plan. Even though the title says "Federal Employees", it is also for Retirees, Family Members of Retirees, and Survivors, . You can enroll during open enrollment season in November. To enroll outside of open season, you must fall into one of three categories as listed on their website at https://www.benefeds.com/education-support/enroll-plan-year. There are several different programs to select from. If you have questions regarding enrollment, please call BENEFEDS Customer Service
In Korea, more common than not, retirees use dental and vision services on the local economy. Korea provides excellent doctors and services at very reasonable prices (fractions), and is very convenient since there are so many. This is by far the most common way of receiving services, primarily because it's the easiest to obtain.
