MEDIPLUS® TRICARE Reserve Select Supplement Insurance Plan
Why choose the MEDIPLUS® TRICARE Reserve Select Supplement Insurance Plan?
MOAA sponsors the MEDIPLUS® TRICARE Reserve Select Supplement Insurance Plan to help reduce your unexpected out-of-pocket expenses. The MEDIPLUS TRICARE Reserve Select Supplement helps cover cost-shares not fully reimbursed by TRICARE for covered doctor visits, hospital stays, surgeries, prescription drug cost-shares and excess charges (up to 15% above the TRICARE allowed amount), once any applicable TRICARE deductible has been met.
The MEDIPLUS TRICARE Reserve Select Supplement has you covered:
- Pays cost-shares and co-pays
- Pays excess charges (up to 15% above the TRICARE allowed amount)
- Affordable members-only group rates
- Guaranteed acceptance for eligible MOAA members and their families — you’re covered immediately for all new health conditions. Any current injuries or illnesses are subject to the Pre-Existing Conditions Limitation and are covered after six months.
Affordable Members-Only Monthly Group Rates
Thanks to the collective buying power of Military Officers Association of America (MOAA) members, you pay an affordable, members-only group rate. See your monthly rate below:
(NOTE: You're classified as a nonsmoker if you haven't smoked cigarettes, cigars or used a pipe or chewing tobacco, nicotine product or snuff during the 12 months prior to the date you apply for coverage.) For your convenience, you'll be billed quarterly. Rates and/or benefits may be changed on a class-wide basis.
Guaranteed Acceptance for You and Your Family
As a member of Military Officers Association of America (MOAA), you are guaranteed acceptance. This means your acceptance into this plan is guaranteed. However, the insurance benefits payable are subject to the Pre–Existing Conditions Limitation.
Your spouse and children (under age 21 or 23 if full–time student or 26 if enrolled in TRICARE Young Adult) are also guaranteed acceptance too. Your Military Officers Association of America (MOAA)–sponsored MEDIPLUS coverage begins the first day of the month after the administrator receives your completed Enrollment Form and your first premium payment. MEDIPLUS covers new health conditions right away. For current health conditions, the waiting period is 6 months.
To learn more about how this plan works to supplement your current TRICARE Reserve Select plan, go to the Forms tab and click on the appropriate link.
The MEDIPLUS TRICARE Reserve Select Supplement offers you and your family cash benefits for Hospital bills, doctor bills, and prescription drugs. Once you pay the annual TRICARE Reserve Select deductible ($150 per person/$300 family), MEDIPLUS works with TRICARE Reserve Select to help cover your medical expenses.
Pays Covered Excess Charges
If your doctor charges you more than what TRICARE allows, you’re left to pay the rest of the bill. Not with MEDIPLUS, because it covers up to 15% of covered excess charges above the TRICARE-allowed amount after the TRICARE deductibles ($150/per person, $300/family) are met. This is especially valuable because excess charges can’t be applied to TRICARE’s annual catastrophic cap (currently $1,000).
Select Your Own Doctor
With MEDIPLUS, you’re free to choose your own TRICARE–authorized doctor or specialist (with no referral) whenever you like.
Current Health Condition Waiting Period Could Be Waived
If you enroll in this MEDIPLUS TRICARE Reserve Select Supplement within 30 days of the date your TRICARE Reserve Select coverage begins, you and your family will qualify for MEDIPLUS without the waiting period for current health conditions.
Change in Military Status? MEDIPLUS Has Other Options for You
If you go back to Active Duty: If you are covered by this MEDIPLUS TRICARE Reserve Select Supplement and then are reactivated to active duty, your family will then qualify for Active Duty TRICARE Select or TRICARE Prime.
If you decide to stay with TRICARE Select, your family may still need a supplement. MEDIPLUS Active Duty Family TRICARE Select Supplement would be available to you. This supplement has similar benefits as the TRICARE Reserve Select Supplement.
If you are Deactivated: If you go back on active duty and purchase TRICARE Reserve Select when you are deactivated, you can switch back to the MEDIPLUS TRICARE Reserve Select Supplement without any waiting period as long as you let us know within 30 days of the date your TRICARE Reserve Select coverage begins.
Should any of these situations occur, please call the Plan Administrator immediately to discuss the best options for you and your family. You must inform the administrator of any changes to your primary TRICARE coverage as you are their only source for that information.
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 Reserve Select 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 email@example.com
Your satisfaction is guaranteed with MEDIPLUS. Take 30 days after you receive your Certificate of Insurance to examine the coverage. Pay for it only after you determine it’s the right protection for you. If you’re not completely satisfied with MEDIPLUS after the 30–day free look, return your Certificate to cancel your request for coverage. You’re under no obligation.
Details – This is a listing of highlights for this Insurance plan. Be sure to review the entire website for a detailed plan description.
|Type of Insurance:
||MEDIPLUS TRICARE Reserve Select Supplement
||Military Officers Association of America (MOAA) members and dependents
||Hartford Life Insurance Company and Hartford Life and Accident Insurance Company, Hartford, CT 06155
|Policy Form Number:
||TRICARE Form Series includes SRP-1269, or state equivalent.
As an MOAA member under age 65, you and your family are eligible for coverage. Coverage will terminate on the date you become eligible for Medicare. 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).
You Cannot Be Singled Out For Cancellation
Your coverage will remain in force as long as you remain an active Military Officers Association of America (MOAA) member, the Master Policy remains in force, and you pay your premium. With regards to your covered spouse and children, their coverage will remain in force as long as your coverage is active, or until they no longer meet the eligibility standards.
A Hospital must be engaged primarily in medical care and treatment of sick and injured persons on an inpatient basis, have full surgical facilities, be under the supervision of legally qualified physicians, and provide 24-hour nursing services by R.N.s to qualify. A sanitarium operated by or certified by the First Church of Christ Scientist, Boston, Massachusetts, also qualifies. A convalescent home; Skilled Nursing Facility; a place for rest, custodial care or for the aged; or a place primarily caring for mental illness, drug addiction, or alcoholism does not qualify. In certain situations, an institution for the treatment of nervous, mental, or emotional disorders is considered a Hospital under the MEDIPLUS TRICARE supplements. Confined or Confinement means being an inpatient in a Hospital or Skilled Nursing Facility due to sickness or injury. Periods of Confinement in a Hospital separated by less than 90 days and due to the same or related causes are considered part of the same Period of Confinement.
Pre-Existing Conditions Limitation:
If you or your covered dependents received medical treatment or advice for a health condition (including pregnancy) during the six months before the date your protection starts, that health condition won’t be covered until the person has been enrolled in the plan for six months. 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 (in Missouri, while sane); 4.) routine physical exams and immunizations, except when: a) rendered to a Child who is less than 6 years of age; or b) required for school enrollment (but not sports physicals) by a Child aged 5 through 11; or c) ordered by a Uniformed Service: (1) for a Covered Spouse or Child of an Active Duty Member; (2) for such spouse or child’s travel out of the United States due to the Member’s assignment; 5.) domiciliary or custodial care; 6.) eye refractions and routine eye exams except when rendered to a child up to 6 years from his or her birth; 7.) eyeglasses and contact lenses; 8.) prosthetic devices, except those covered by TRICARE; 9.) cosmetic procedures, except those resulting from Sickness or Injury while a Covered Person; 10.) hearing aids; 11.) orthopedic footwear; 12.) care for the mentally or physically incapacitated if: a) the care is required because of the mental or physical incapacitation; or b) the care is received by an Active Duty Member’s child through the TRICARE Extended Care Health Option (ECHO); 13.) drugs which do not require a prescription, except insulin; 14.) dental care unless such care is covered by TRICARE, and then only to the extent that TRICARE covers such care; 15.) any confinement, service, or supply that is not covered under TRICARE; 16.) Hospital nursery charges for a well newborn, except as specifically provided under TRICARE; 17.) any routine or newborn care except Well Baby Care, as defined; 18.) expenses which are paid in full by TRICARE; 19.) any part of a covered expense which the Covered Person is not legally obligated to pay because of payment by a TRICARE alternative program; and 20.) any claim under more than one of the TRICARE Supplement Plans, or under more than one Inpatient Benefit or more than one Outpatient Benefit of the TRICARE Supplement Plans. If a claim is payable under more than one of the stated Plans or Benefits, payment will only be made under the one that provides the highest coverage, subject to the Pre-Existing Conditions Limitation. 22.) any expense applied to the TRICARE Outpatient Deductible, TRICARE Point-of-Service Deductible, Retiree Inpatient-Only Supplement Deductible or Retiree Inpatient/Outpatient Supplement Deductible.
Nervous, Mental, Emotional Disorder, Alcoholism, and Drug Addiction Limitations
The coverage provided under the TRICARE Supplement does not cover inpatient treatment for mental, nervous, or emotional disorders in excess of 45 days if under age 19, or in excess of 30 days if age 19 or older (or 90 days if approved by the TRICARE Select) in any one calendar year. Outpatient benefits for such disorders are limited to $500 during any period of 12 consecutive months. In addition, for Mental Illness we will pay up to 150 days of inpatient care for covered expenses for a covered dependent child up to age 21.
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 co-payment based on a means test per Public Law 99 Section 272. This law specifically applies only to the veteran and not the insurance company. Hartford Life and Accident Insurance Company is not liable for payment of these charges.
Backed by Military Officers Association of America (MOAA)
Military Officers Association of America (MOAA) endorses only one group of TRICARE Supplements on the market: MEDIPLUS. You can trust Military Officers Association of America (MOAA) to recommend only the best plan that meets their strict guidelines.
Plan may not be available in all states.
This website explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life Insurance Company and Hartford Life and Accident Insurance Company detail exclusions, limitations and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.
Your association shares a financial interest in this program, which benefits the entire membership.
The information on this site describes benefits available through this insurance program and is intended to provide a brief overview of the coverage. In the event of any conflict or inconsistency between the information on this site and the information contained in the underlying plan documents, the plan documents will in all respects control and govern. If any provision is not explained or only partially explained, your rights will always be determined under the provisions of the underlying plan documents. Insurance coverage and availability may differ by state. For complete plan details, please contact the Program Administrator, Military Officers Association of America (MOAA) Insurance Plans at 1-800-247-2192, Monday-Friday, 7:30 a.m. - 5:00 p.m. and Saturday, 8:00 a.m. - 1:00 p.m. Central Time
TRICARE Form Series includes SRP-1269, or state equivalent.