Military Insurance

TRICARE is a set of regionally managed health plans available worldwide and managed regionally in six separate TRICARE regions.  Only the first three would apply to services provided in the United States:

• TRICARE North - . Policy, credentialing, contracting, and overall administration by Health Net Federal Services, Inc. - claims are processed by PGBA, LLC.
• TRICARE South  - Policy, credentialing, contracting, and overall administration by Humana Military Healthcare Services - claims are processed by PGBA, LLC.
• TRICARE West Policy, credentialing, contracting, and overall administration by TriWest Healthcare Alliance - claims are processed by WPS Health Insurance but most provider interaction is with TriWest.
• TRICARE Europe
• TRICARE Pacific
• TRICARE Latin America/Canada

While most active military patients are treated within the military health facilities, most non-military home infusion or DME providers may treat non-active military, dependents, retired military, etc. covered by the principal TRICARE plans.  They are as follows:

• TRICARE Extra (This is similar to a PPO)
• TRICARE Prime (similar to an HMO) – Active duty service men and woman are limited to enroll in this program.
• TRICARE Standard (similar to traditional indemnity insurance)
• TRICARE Reserve Select (TRS)  - This program is premium based for eligible National Guard/Reserve members.
• TRICARE for Life (supplements Medicare)  Members are “dual-eligible” meaning they have both Medicare [Part A & B] and TRICARE.
• TRICARE Pharmacy Program (retail drug plan)

You can learn more about our outsourced reimbursement services, by calling (888) 424-2455, e-mailing us at marketing@advantage-reimbursement.com, or filling out this info request form.