TRICARE Supplemental Insurance: The Key to Controlling Out-of-Pocket Costs

For many American families, financial stability is a balancing act. One medical emergency could push them over the edge. It's the sort of fear that can keep adults aware at night, but for eligible military retirees and their families, TRICARE supplement insurance provides peace of mind.

Medical Emergencies Can be Unpredictable

Everyone knows they're supposed to create an emergency fund. But here's the catch – no one knows exactly how much should go in that fund. Financial experts may recommend saving an amount equal to three to six months salary, and that's a pretty good rule of thumb, but the reality is that no one really knows exactly how they'll need in an emergency. Emergencies are, by their nature, hard to predict – and that goes double for medical emergencies.

The Commonwealth Fund says that 72 million working-age Americans are paying off medical debt or have medical bills, and NBC says that about one in three American voters worries they wouldn't be able to cover healthcare costs in 2020. 

Even with Health Insurance, Medical Bills Can Add Up

Health insurance is supposed to cover routine care and medical emergencies, but it doesn't mean you won't have any out-of-pocket costs. In addition to the premium that you pay each month, you may be responsible for a variety of costs whenever you receive care.

According to U.S. News, a study found that people with private insurance could end up paying an average of $3,800 in out-of-pocket costs if they require hospitalization for COVID-19. Some people end up paying much more for medical emergencies . In one example, NPR says that a man was billed $28,000 after he needed surgery because his appendix was about to burst – and that bill was after his insurer had paid its share.

If you or someone in your family needs medical care, here's some of what you could end up paying out of pocket:

• The Deductible. Most health insurance plans, and many other types of insurance policies, have a deductible. You have to meet the deductible before the plan starts paying its share of medical costs. For example, if your plan has a $1,000 deductible, you will have to pay $1,000 out of pocket before your plan starts paying for care. 
• The Copay. Each time you receive medical care or fill a prescription, you may be required to pay a copay. This is your share of the costs. For example, if you have a $30 copay for doctor visits, you will have to pay $30 out of pocket each time you see your doctor. Some health insurance plans have separate – and often more expensive – copays for specialists visits and emergency room visits. 
• Non-Network Charges. Many health insurance plans use networks of providers and facilities. If you go to a healthcare facility that's in-network and see all in-network providers, your care will be covered, although you will still be responsible for costs like deductibles and copays. If you go out of network, your care may not be covered, and you’ll have to pay out of pocket. This can be a problem when people need to see a specialist who is out of network, and if they require surgery and cannot check whether each and every person involved in their care is in their network, and this is a big part of the reason why people sometimes get hit with massive surprise medical bills.

Solution: TRICARE Supplemental Insurance

If unpredictable medical costs are the problem, a TRICARE Supplement may be the solution.

TRICARE Supplement plans are designed to wrap around TRICARE health insurance pans. If you are enrolled in a TRICARE plan, and you are not on active duty or eligible for Medicare, you are eligible for a TRICARE Supplement plan.

When you are enrolled in a TRICARE Supplement plan, you are responsible for the plan’s premium and deductible. In exchange, you receive many advantages:

• Your out-of-pocket costs are kept low. For example, when you use the TRICARE Supplement with TRICARE Select, the TRICARE Supplement pays all copays after the deductible is met.
• Non-network providers are covered.
• Your out-of-pocket costs become predictable.
• You can take the TRICARE Supplement with you when you change jobs. The plan is portable, so even if you get the plan through your job, you can take it with you if you leave.

Want to Explore Your TRICARE Supplement Options?

Contact us to learn more.