RAUS Tricare Insurance Coverage

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Coverage

Here's How The Tricare Standard/Extra Supplement Works To Pay What Tricare Standard/Extra Doesn't Pay

CARE REQUIRED	TRICARE EXTRA/STANDARD PAYS	YOUR TRICARE EXTRA/STANDARD SUPPLEMENT PAYS
Inpatient care in civilian hospitals for RETIREES and dependant family members (room, board, supplies and staff services billed by the hospital).	The Tricare Standard/DRG amount (contracted rate for Tricare Extra) minus your cost share.	Comprehensive Plan & High Option II Plan - The lesser of $414/day or 25% of billed amount, not to exceed the Tricare Standard DRG amount (lesser of $250/day or 25% cost share** of the contracted rate for Tricare Extra) PLUS 100% of covered excess charges up to the reasonable and customary community standard level. (After you satisfy the fiscal year plan deductible.)
Inpatient care in civilian hospitals for RETIREES and dependent family members (doctors, and other inpatient services not billed by the hospital).	75% of the Tricare Standard allowed amount (80% for Tricare Extra) for doctors and other [professional services.	Comprehensive Plan & High Option II Plan - Your cost share** PLUS 100% of eligible charges up to the reasonable and customary community standard level.
Inpatient care in military hospitals.	All but the daily subsistence fee.	All Plans - The daily subsistence fee.
Outpatient care for RETIREES and dependent family members (office visits, clinics, lab, prescription drugs, etc.)	75% of the Tricare Standard allowed amount (80% for Tricare Extra) after you pay the Tricare Outpatient Deductible .	Comprehensive Plan - After you staisfy the fiscal year plan deductible of $75 per person, and $150 family maximum, the plan will reimburse you (1) the Tricare fiscal year outpatient deductible of $150 per person and ($300 family maximum,* (2) your cost share and (3) 100% of covered excess charges up to the reasonable and customary community standard level. High Option II Plan - Your cost share PLUS 100% of eligible charges up to the reasonable and customary community standard level, AFTER you pay the fiscal year plan deductible of $150 per person, $300 family maximum.*
Inpatient care in civilian hospitals for ACTIVE DUTY dependents.	All allowable charges except daily subsistence fee or $25, whichever is greater.	Active Duty Plan - $25 or the daily subsistence fee, whichever is greater, PLUS 100% of covered excess charges up to the reasonable and customary community standard level.
Outpatient care for ACTIVE DUTY dependents (office visits, clinics, lab, prescription drugs, etc.)	80% of the Tricare Standard allowed amount (85% for Tricare Extra) after you pay the Tricare Outpatient Deductible.	Active Duty Plan - Your cost share** PLUS 100% of covered excess charges up to the reasonable and customary community standard level, AFTER you pay the Tricare Extra Standard Outpatient Deductible.*

* Expenses incurred to satisfy the fiscal year Tricare Standard/Extra Outpatient Deductible will be applied to the Standard Plan deductible. The supplemental Standard Plan does not pay the excess charges over the Tricare Standard allowed amount.
** Until the Tricare Cap is met.
NOTE: Inpatient and outpatient expenses can be used to satisfy the fiscal year plan deductible.

To download and print the complete insurance plan, coverage, rates and necessary forms (including the RAUS Membership Application) in Adobe Acrobat PDF format, click here.

For more about Tricare Supplement Insurance, select:
[ The Plan | Coverage | Group Rates | About Us | Enrollment ]

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