Other health insurance (OHI)

Other health insurance is any health insurance you have besides TRICARE, such as a plan through an employer. By law, TRICARE generally pays after it.

Applies to: All TRICARE plans · All regions

Other health insurance (OHI) is, in TRICARE’s words, any health insurance other than TRICARE. It can be through your employer or a private insurance program.

Who pays first

By law, TRICARE pays after all other health insurance. Your other plan processes the claim first. The same goes at the pharmacy: your other plan pays first and TRICARE pays second.

TRICARE lists exceptions, meaning coverage that TRICARE does not treat as other health insurance for this rule:

• Medicaid
• TRICARE supplements (see TRICARE supplement)
• State victims of crime compensation programs
• Other federal government programs identified by the Director of the Defense Health Agency, for example the Indian Health Service

Tell TRICARE about it

TRICARE asks you to tell your TRICARE contractor and your doctors when you have other health insurance, and to complete and return your region’s other health insurance form. You must also report when the coverage ends.

TRICARE warns that if you do not, it may deny your claims, and if TRICARE pays first and later finds out you had other coverage, it will take back what it paid.

Gaining or losing other insurance

Losing or gaining other health insurance appears on TRICARE’s life events list and may open a 90-day period to change your plan. Check TRICARE’s page on losing or gaining OHI for your situation.

TRICARE’s full explanation is on its Using Other Health Insurance page.