Available to TRICARE Beneficiaries, regardless of Rank, Service or Duty Status
Eligibility – TRICARE SUPPLEMENT
You are eligible to enroll if you are a TRICARE eligible recipient, under age 65, and entitled to retired (Military), retainer, or equivalent pay. If you are age 65 or over and ineligible for Medicare, you may
apply for the plan by attaching a copy of your Social Security Notice of Disallowance of Benefits to your Enrollment Form.
If you are:
- Retirees of the uniformed services, their spouse and unmarried dependent children (under age 21 or 23 if a full-time student)
- Spouse or surviving spouse of retired military personnel and dependent children under age 21 or 23 if a full-time student.
- Retired Reservists and National Guard members (gray area retirees) under age 60 and enrolled in TRICARE Retired Reserve (TRR)
- Spouse and unmarried eligible dependent children (under age 21 or 23 if a full-time student) who are eligible for CHAMPVA
Your coverage and that of your covered dependents becomes effective on the ﬁrst day of the month following receipt of your enrollment form and ﬁrst premium payment. If, on that day, you or a covered dependent are conﬁned in a hospital, the effective date will be the day following discharge from the hospital.
Deferred Effective Date: If on the date that You are to become covered under the Policy you are conﬁned in a Hospital, your coverage will be deferred until the ﬁrst day after You are discharged.
Deferred Effective Date (Dependent): If on the date that an Eligible Dependent is to become covered under the Policy he or she is conﬁned at home, in a Hospital or elsewhere because of injury or sickness, coverage of such person will be deferred until the ﬁrst day after he or she is discharged from the Hospital or place of conﬁnement.
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.
Newborn children not named in your enrollment form are automatically covered from birth for injury or sickness, including treatment of congenital defects and birth abnormalities, for 31 days. You must notify the Plan Administrator in writing and pay the additional premium due within 31 days of birth for coverage to continue beyond this period. Insured children who are incapable of self-sustaining employment because of mental retardation or physical disability- and who are unmarried and chiefly dependent on the insured member for support and maintenance—may continue coverage past policy age limits, with a dependent. Rates are based on the attained age of the insured person and increases as you enter each new category. Rates and /or benefits may be changed based on a class basis.
Although the Plan works in all 50 States, the Plan is currently not available in CO, ME, NH, OR, WA.
* Services are covered up to the legal limit maximum.
- The Corporate Plan Sponsor: Government Employee Association (GEA)
- Plan Administer: Selman and Company
- Underwritten by: Harford Life and Accident Insurance Company, Harford, CT 06155
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