Other Health Insurance

Other Health Insurance (OHI) refers to any health insurance coverage a TRICARE beneficiary has in addition to TRICARE. This includes employer-sponsored plans, individual marketplace plans, Medicaid, Medicare, and any other health coverage. Understanding how OHI interacts with TRICARE is important for maximizing benefits and minimizing costs.

How OHI works with TRICARE: • OHI is typically the primary payer (pays first) • TRICARE becomes the secondary payer • TRICARE may cover remaining costs after OHI pays • Double coverage can reduce or eliminate out-of-pocket expenses

Common types of OHI: • Employer-sponsored health insurance • Spouse's employer plan • Marketplace (ACA) plans • Medicaid • Medicare (for age 65+) • VA benefits (for certain services)

Important OHI rules: • You must report OHI to your regional contractor • Filing claims with both OHI and TRICARE may be required • OHI deductible payments may count toward TRICARE deductible • Having OHI does not change your TRICARE eligibility

Beneficiaries should carefully evaluate whether maintaining OHI is cost-effective. In some cases, the premiums for OHI may not be worth the additional coverage, especially if TRICARE provides adequate benefits on its own.