Coverage is Portable.
You can rest assured your protection can stay with you wherever you go. Even if you change jobs or move, you can keep your MEDIPLUS® protection. (Unlike employer-provided plans that end when you leave your job.)
- Moving from an employer plan? You’ll qualify for full MEDIPLUS® coverage from Day 1 … with no waiting period for current health conditions … if you enroll within 30 days after your civilian employer-sponsored benefits end because you are no longer an eligible participant (for example: if you change jobs, move or retire). If you voluntarily leave your civilian employer plan while you’re still eligible for coverage, you will not be covered for current health conditions until after the six-month waiting period.
- Are you just eligible for TRICARE? You’ll have NO waiting period for current health conditions when you enroll within 30 days of the date of your initial eligibility for TRICARE Retired Reserve benefits.
Seamless transition to other MEDIPLUS® coverage when your military status changes. Once your TRICARE Retired Reserve coverage ends, you can change your MEDIPLUS® coverage to a TRICARE Select Supplement to pair it with TRICARE Select. And if you switch to TRICARE Prime for retirees, you can also switch to a MEDIPLUS® TRICARE Prime Supplement you just need to notify the MOAA Insurance Plans Administrator of this change.
DirectClaim: MOAA’s electronic filing process for MEDIPLUS® TRICARE Supplement claims
Filing MEDIPLUS® claims is fast and easy with DirectClaim, another unique benefit to MEDIPLUS®. With DirectClaim, you will not have to complete MEDIPLUS® claim paperwork after you access most of your eligible TRICARE benefits. You will be informed when your claim is filed electronically by a message on your MEDIPLUS® Explanation of Benefits (EOB) form.
Please be aware that some TRICARE Supplement claims cannot be processed electronically, such as any prescription claims and most Skilled Nursing or Skilled Nursing Facility, nursing home claims and claims filed from overseas. For these, you will need to submit paper claim filings to MEDIPLUS®. Claim forms are accessible on this website.
If a claim for service is submitted through DirectClaim and TRICARE has paid the provider(s) directly, any payment due under a MEDIPLUS® TRICARE Retired Reserve Supplement will be paid directly to the provider(s).
It’s important that the MEDIPLUS® applicant’s name appears on the enrollment form the same as it is on their military ID card to ensure proper claims processing.
If you have any questions about DirectClaim, please call the MOAA Insurance Plans Administrator at 1-800-247-2192 or email moaa.service@getamba.com.
You can count on MEDIPLUS® to help take care of your family.
MEDIPLUS® is ideal for the whole family – yourself, your spouse and your kids. It’s even perfect for your kids at college. It provides valuable coverage at affordable group rates. And, MEDIPLUS® can be used at most student health service centers where TRICARE is accepted. But that’s not all.
MEDIPLUS® will be there for your family, even if something happens to you. If you die, your eligible spouse’s MEDIPLUS® coverage will continue at no cost until he or she remarries, reaches age 65 or becomes Medicare-eligible.
Children can continue their MEDIPLUS® protection premium-free for ten full years, or until they marry or reach age 21 (23 if a full-time student or 26 if enrolled in TRICARE Young Adult; or age 25 if a resident of Montana). Your family automatically qualifies for this additional benefit as long as you, your spouse and children are continuously covered by MEDIPLUS® for at least six months before you die.
This benefit is not available with the MEDIPLUS® TRICARE Prime Supplement Plan, but would continue if your family moves from the MEDIPLUS® TRICARE Retired Reserve Supplement to the MEDIPLUS® TRICARE Select Supplement coverage for retirees.
Eligibility:
Retired National Guard and Reserve members under age 60 and covered by TRICARE Retired Reserve. You can also enroll your spouse or children without enrolling yourself. Your spouse is eligible as long as he/she is under age 65 and not legally separated or divorced from you. Your unmarried children are eligible if they are under age 21 (23 if enrolled full-time in higher-learning or 26 if enrolled in TRICARE Young Adult; or age 25 if a resident of Montana). You and your family must not yet be eligible for Medicare. Member and Spouse cannot duplicate coverage by enrolling as dependents of each other.
Termination:
Your MEDIPLUS® protection will not be canceled due to claims or a change in your health, and you cannot be singled out for a rate increase. Your coverage continues as long as you pay your premiums when due, keep your Military Officers Association of America (MOAA) membership, remain ineligible for Medicare and the MEDIPLUS® master policy remains in force. Your dependent’s coverage will remain in effect as long as your coverage is active, premiums are paid, and they meet eligibility requirements. Your spouse is eligible for coverage as long as they are not legally separated or divorced from you.
Hospital/Skilled Nursing Facility:
Hospital means an institution which TRICARE recognizes as a hospital. Skilled Nursing Facility means an institution that: operates pursuant to law; in addition to room and board accommodations, is primarily engaged in providing skilled nursing care under the supervision of a Physician; provides continuous 24 hour a day nursing service by or under the supervision of a registered graduate nurse (R.N.); and maintains a daily medical record of each patient. Skilled Nursing Facility does not mean a Hospital or any institution or part thereof that is used mainly as a home or place for: the aged, or for rest, custodial or educational care; alcoholism and drug addiction; the treatment of Mental Illness. Confined or Confinement means being an inpatient in a Hospital or Skilled Nursing Facility due to Sickness or Injury.
Pre-Existing Conditions Limitation (Waiting Period for Current Health Conditions):
We will not pay a benefit under The Policy for any expenses Incurred: during the first 6 months of the Covered Person’s coverage; and which are the result of Pre-existing Conditions. Please consider this limitation before canceling any other health insurance you may have.
Exclusions and Limitations:
These TRICARE Supplements do not cover: 1.) injury or sickness resulting from war or act of war, whether war is declared or undeclared; 2.) intentionally self-inflicted injury; 3.) suicide or attempted suicide, whether sane or insane. The Policy limits coverage for: 1) routine physical exams and immunizations, except when: a) rendered to a child up to 6 years from the child’s birth; or b) ordered by a Uniformed Service: i)for a Covered Dependent of an Active Duty Member; ii)for such Dependent’s travel out of the United States due to your assignment; or c) required for school enrollment (but not sports physicals) by a Covered Child aged 5 through 11; 2) domiciliary or custodial care; 3) eye refractions and routine eye exams except when rendered to a child up to 6 years from the child’s birth; 4) eyeglasses and contact lenses; 5) prosthetic devices, except those covered by TRICARE; 6) cosmetic procedures, except those resulting from Sickness or Injury, while a Covered Person; 7) hearing aids; 8) orthopedic footwear; 9) care for the mentally or physically incapacitated if: a) the care is required because of the mental or physical incapacitation; b) or the care is received by an Active Duty Member’s child who is covered by the TRICARE Extended Care Health Option (ECHO); 10) drugs which do not require a prescription, except insulin; 11) dental care unless such care is covered by TRICARE, and then only to the extent that TRICARE covers such care; 12) any confinement, service, or supply that is not covered under TRICARE; 13) Hospital nursery charges for a well newborn, except as specifically provided under TRICARE; 14) any routine newborn care except Well Baby Care; 15) any expense or portion thereof which is in excess of the Legal Limit; 16) expenses in excess of the TRICARE Catastrophic Cap; 17) that part of any Covered Expense which is in excess of the TRICARE Allowed Amount, except as otherwise stated in the plan benefits; 18) expenses which are paid in full by TRICARE; 19) any expense or portion thereof applied to the TRICARE Outpatient Deductible; 20) purchase of a wheel chair, hospital type bed, or other durable equipment, unless TRICARE determines that purchasing the equipment costs less than renting it; 21) any part of a Covered Expense which the Covered Person is not legally obligated to pay because of payment by a TRICARE alternative program; 22) any claim under more than one of the TRICARE Supplement Plans. If a claim is payable under more than one plan or benefit, payment will only be made under the provision that provides the highest coverage.
Important Information Regarding Veterans’ Administration (VA) Hospitals — TRICARE supplement insurance policies pay benefits only after TRICARE has first reviewed and approved the expense. A review by TRICARE results in a TRICARE Explanation of Benefits (“EOB”). Many VA Hospitals currently do not submit their claims through TRICARE. Only claims TRICARE processes, resulting in an EOB, are subject to benefits under Hartford Life and Accident Insurance Company’s TRICARE supplement insurance policies. If you use VA facilities for your care, please be aware of this TRICARE supplement policy requirement.
VA Hospitals also can charge the veteran a Category C copayment based on a means test per Public Law 99 Section 272. This law specifically applies only to the veteran and not the insurance company. The Hartford is not liable for payment of these charges.
Important Information About This Coverage
| Type of Insurance: |
MEDIPLUS® TRICARE Retired Reserve Supplement |
| Designed For: |
Military Officers Association of America (MOAA) members and dependents |
| Underwritten by: |
Hartford Life and Accident Insurance Company, One Hartford Plaza, Hartford, CT 06155 |
| Policy Form Number: |
TRICARE Form Series includes GBD-3000, GBD-3100, or state equivalent. |
| Policy Number: |
AGP-5889 |
| Issue Ages |
Through age 59 |
moaa.service@getamba.com
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