If TRICARE is the patients secondary insurance, does TRICARE pay the patient liability after their primary insurance processes the claim?
When a patient has other health insurance, TRICARE coordinates benefits with the other health insurance. If the provider is a network provider or a non-network provider accepting assignment, they have agreed to accept the liability after the primary insurance made payment or what TRICARE would have paid without other health insurance. If the primary insurance payment is more than the TRICARE allowable, the primary insurance has satisfied the TRICARE liability. The patient is not responsible for the TRICARE co-pays / cost shares in these instances. If the patient has Medicare as their primary coverage, TRICARE accepts Medicare’s allowable amounts and, in most case, pays the remaining liability.
Related Questions
- I received an Explanation of Benefits from TRICARE stating the other health insurance has been paid in full. How could the primary insurance pay the charges in full when they only paid 80%?
- If TRICARE is the patients secondary insurance, does TRICARE pay the patient liability after their primary insurance processes the claim?
- How does the patient pay for the test if they do not have either Medicare Part B as a primary insurance or private insurance?
