TRICARE Supplemental Insurance Plan | Rates 2014

Available to TRICARE Beneficiaries, regardless of Rank, Service or Duty Status

TRICARE Supplement Insurance Rates (High Option)

TRICARE ANNUAL DEDUCTIBLE (Standard/Extra)

  • TRICARE Deductible - E-4 and below, $50 member only coverage or a maximum of $100 per family
  • TRICARE Deductible - E-5 and above, $150 member only coverage or a maximum of $300 per family
  • SUPPLEMENT PLAN Deductible, $250 member only or a maximum of $500 per family per year
Premiums illustrated are Per Person.
Age of Retiree, Spouse, Widow(er), Former Spouse Monthly Check-O-Matic Quarterly Semi-Annual Annual
Under 40 $26.33 $79.00 $158.00 $316.00
40 - 44 $28.33 $85.00 $170.00 $340.00
45 - 49 $31.67 $95.00 $190.00 $380.00
50 - 54 $40.00 $120.00 $240.00 $480.00
55 - 59 $50.33 $151.00 $302.00 $604.00
60 - 64 $55.67 $167.00 $334.00 $668.00
Each Child $21.00 $63.00 $126.00 $252.00

It's So Easy To Enroll in the TRICARE SUPPLEMENT

Click Here for ENROLLMENT FORM

TRICARE SUPPLEMENTAL INSURANCE

Premiums illustrated are Per Person. Premiums increase based on your effective date of coverage and as you move from one age bracket to another. The insurance company reserves the right to change benefits or premiums on a group wide basis.

Important Notice

This coverage is available to AMRA members and their dependents only. If you are not a member of AMRA ($25 annual fee), it is easy to become one. A membership application is included with the TRICARE SUPPLEMENT Enrollment Form

Pre-Existing Conditions Limitation

Any injury or sickness whether diagnosed or undiagnosed, for which a covered person received medical care or treatment within the 6 month period preceding the effective date of his or her insurance will not be covered until the coverage has been in effect for 6 months. However, new conditions will be covered immediately.

The Pre-existing condition limitation may be waived under the following conditions:

For individuals who are newly retired from active duty military and who enroll in the plan within 63 days of the military retirement date. Application for coverage should include a copy of their DD-214.

For individuals who were previously enrolled in a non-TRICARE Supplement Employer Group Plan and loses that coverage due to involuntary termination. Such individuals must enroll in the Supplement Plan within 31 days following the termination date of the prior insurance plan. Application for coverage under the Supplement Plan should include a copy of the Certificate of Creditable Coverage for the prior group insurance plan.

For inquiries, call TRICARE Supplement Insurance office toll-free at: (800) 638-2610

Before you begin enrollment, review TRICARE SUPPLEMENT Features, Benefits Summary and Rates .

IMPORTANT NOTICE:


The Plan is currently not available in CO, ME, MT, NH, NV, OR, SD, WA, VT.