TRICARE For Life Claims Filing: Essential Guidance for Medicare Beneficiaries

TRICARE For Life (TFL) functions as a secondary payer to Medicare for eligible military beneficiaries. Typically, health care providers file claims directly with Medicare, which pays its share before forwarding the claim to WPS Government Services, the TFL contractor, to cover TRICARE’s portion. However, certain situations require beneficiaries to submit claims themselves to WPS for processing. When filing claims personally, beneficiaries should be prepared to provide detailed medical documentation, including proof of payment for care received overseas, where TRICARE pays first and Medicare does not reimburse. Overseas claims have a longer filing window of three years, compared to one year for domestic claims. The importance of presenting both Medicare and military ID cards at medical appointments is emphasized to facilitate smooth claims processing. Additionally, beneficiaries are encouraged to seek care from Medicare-participating providers to minimize out-of-pocket expenses. This guidance highlights ongoing administrative processes critical to managing dual health coverage under Medicare and TRICARE, underscoring compliance with filing deadlines and documentation requirements to ensure timely reimbursement. The coordination between Medicare and TRICARE reflects a structured approach to serve military retirees and their families efficiently. For support, beneficiaries can refer to the TRICARE For Life handbook and contact WPS Government Services. The article serves as an informational resource for healthcare providers, payers, and military families navigating dual coverage complexities.