Providers must verify TRICARE eligibility for beneficiaries at the time of service. Providers should ensure the patient has a valid Common Access Card (CAC), uniformed services ID card or eligibility authorization letter. Be sure to check the expiration date and make a copy of both sides of the ID card for your patient files. If the beneficiary prefers not to have you copy the card, they must ensure you have the valid ID information and eligibility dates.
A CAC or ID card alone does not prove TRICARE eligibility. Providers should verify eligibility with Humana Military. The quickest, easiest way to do this is through provider self-service
Active Duty Service Members (ADSM), family members over age 14, retirees and family members will have one of two valid military ID cards shown below.
Note: TRICARE beneficiaries can include active duty military and families, retired military and families and survivors, as well as Reserve/Guard and their families.
Note: Beneficiaries who are dual-eligible will have Medicare Part A and Part B and TRICARE.
All eligible family members and survivors age 75 or older are issued permanent ID cards. These cards should read INDEF (i.e., indefinite) in the expiration date box.
TRICARE is the secondary payer to all health benefits and insurance plans, with the exception of Medicaid, Indian Health Services and other public programs identified by the government. Always check for OHI and status of OHI with the patient at each visit.
National Guard and Reserve Component members are entitled to medical care coverage under TRICARE while in performance of military duties or if they have incurred or aggravated a medical condition resulting from military service. If information in your records indicates this may be the case, please file your claim with Humana Military for review and adjudication.