Dual Eligible Beneficiaries/TRICARE For Life
When a beneficiary has both Medicare and TRICARE, the beneficiary is considered dual eligible. His or her TRICARE option is called TRICARE For Life and claims are handled by Wisconsin Physicians Service (WPS) – Military and Veterans Health.
In most cases, Medicare serves as primary payer and TRICARE as secondary payer, except when:
- Medicare does not offer coverage or the Medicare benefit has been exhausted, TRICARE will be the only payer and the beneficiary will be responsible for applicable deductibles and cost-shares.
- Medicare offers coverage and TRICARE does not, Medicare serves as the only payer and the beneficiary will be responsible for applicable deductibles and cost-shares.
- Neither Medicare nor TRICARE offer coverage, beneficiaries are responsible for the entire bill.
If the beneficiary has other health insurance (OHI) as well as Medicare and TRICARE, TRICARE will pay after Medicare and the OHI. Once Medicare and the OHI have processed the claim, the beneficiary should file a TRICARE claim with WPS.
Read more about TRICARE and OHI guidelines on our Other Health Insurance page.
