TRICARE Supplement Plan
Selman & Company Supplement plans are ready when you need them
The costs of managing a military family's health care expenses can mount up quickly, especially if you desire specialty care outside the military system. As a result, the Individual TRICARE Supplement Plan can become an important asset for you and your family.
Regardless if you are seeking flexible health care options with TRICARE Standard/Extra or if you are comfortable sticking with TRICARE Prime, we have developed a supplemental solution for your needs.
| TRICARE SUPPLEMENT PLAN | |||
| IF YOU HAVE TRICARE STANDARD OR TRICARE EXTRA | |||
| TRICARE PAYS | Supplement Pays | YOU PAY | |
| Deductible | |||
| Individual | $150 | $0 | $150 |
| Family | $300 | $0 | $300 |
| Professional Services Cost Share | |||
| In Network | 80% | 20% | $0 |
| Out Of Network | 75% | 25% | $0 |
| Prescription Drug Copayments | |||
| Generic RX | All but $10 | $10 | $0 |
| Brand Name RX | All but $24 | $24 | $0 |
| Non-Formulary RX | All but $50 | $50 | $0 |
| Other Out Of Pocket Charges | |||
| Excess Charges* | 0% | 100% | $0 |
| IF YOU HAVE TRICARE PRIME | |||
| TRICARE PAYS | Supplement Pays | YOU PAY | |
| Deductible | |||
| Individual | $300 | $0 | $300 |
| Family | $600 | $0 | $600 |
| Professional Services Cost Share | |||
| In Network | All but copays | Copays | $0 |
| Out Of Network | 50% | 50% | $0 |
| Prescription Drug Copayments | |||
| Generic RX | All but $10 | $10 | $0 |
| Brand Name RX | All but $24 | $24 | $0 |
| Non-Formulary RX | All but $50 | $50 | $0 |
| Other Out Of Pocket Charges | |||
| Excess Charges* | 0% | 100% | $0 |
TRICARE SUPPLEMENT PLAN DETAILS
The supplement plan helps to better protect you against out-of-pocket expenses. It can pay your:
- Cost shares and
- Co-pays and
- Prescription fees -and-
- Excess charges*
The Individual TRICARE Standard/Extra High Option II Plan
This plan pays 100% of cost shares and covered excess charges up to the legal limit. It has a fiscal year plan deductible of $250 per person and $500 family maximum.
The Individual TRICARE Prime Supplement
This plan covers cost shares and co-payments up to catastrophic limits; however, the plan does not cover the Prime Point of Service (POS) deductible ($300/individual and $600/family).
