MCA&F TRICARE Supplement - mca

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TRICARE Supplement Insurance Plan

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TRICARE Supplement

TRICARE Supplements aren't created equal. That's why only one TRICARE Supplement has earned MCA&F's stamp of approval for quality, cost-savings and service. It's the MCA&F TRICARE Supplement coverage.

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Tricare Change Statement

Effective 1/1/18, the TRICARE program is implementing new changes that will affect this AUSA's Mastercare Supplement Insurance Plan. While we are working to implement these changes on this website, please visit https://www.tricare.mil/changes/select to learn more.

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Overview

MarineCARE Helps Pay Out-of-Pocket Expenses

MarineCARE helps add to your health care safety net for the medical bills left behind by TRICARE Standard and TRICARE Prime. In a nutshell, it helps pay deductibles… cost-shares… and doctor or hospital fees that are more than the "TRICARE-allowed amount."

Plus, MCA&F's MarineCARE TRICARE Supplement Insurances also helps you stay more in control of your health care by protecting your right to see the TRICARE authorized doctor of YOUR choice. There are NO preferred provider lists to worry about. NO doctor or hospital networks to keep track of. NO referrals required.

You Cannot Be Turned Down

And best of all, ACCEPTANCE IS GUARANTEED*, subject to Pre-Existing Conditions, for active duty families, retirees and their families. If you're under age 65 and qualify for TRICARE, you cannot be turned down* for MarineCARE. Children are eligible until the date they attain age 21 or 23 if a full-time student. It's as simple as that. We won't even ask if you smoke.

NO OBLIGATION WITH 30-DAY FREE LOOK

You're under no obligation when you enroll for your MCA&F MarineCARE TRICARE Supplement benefits today. That's because you're fully backed by a 100% Satisfaction Guarantee. As soon as you sign up, we'll mail your Certificate of Insurance outlining the full terms and conditions of this exclusive MCA&F benefit program. Take up to 30 days to look it over. If it wasn't what you had in mind, mail back the Certificate for a 100% refund; less any claims paid.

ACTIVATE IMMEDIATELY FOR PROMPT COVERAGE

Activating MarineCARE is straight forward. Everything you need to enroll is here on this website.

Your MarineCARE benefits start on the first of the month after the plan administrator receives your Enrollment Form and first premium payment. Of course, all new health conditions will be covered immediately. Any illnesses or injuries that you received medical care for during the past twelve months will be covered as soon as you go twelve months without treatment or are in the plan for six months – whichever comes first. MCA&F's MarineCARE Program is a group plan. So you can rest assured your rates will not go up due to changes in your health or because you file a lot of claims. And you can keep your MarineCARE coverage until you qualify for Medicare at age 65 as long as you pay your premium on time, remain an MCA&F Member and the group policy remains in force. (Your spouse's coverage continues until age 65 unless he/she is not eligible for Medicare. Children's coverage ends on the date they attains age 21 or age 23 if a full-time student.)

*This policy is guaranteed acceptance, but does contain a Pre-Existing Condition Limitation. Please refer to the enclosed Terms Tab for more information on exclusions and limitations, such as Pre-Existing Conditions.

TRICARE Form Series includes SRP-1269, or state equivalent.

Benefits

MarineCARE Helps Pay Out-of-Pocket Expenses

Helps Pay Your Covered Medical Costs

MarineCARE steps in to help by paying your covered medical bills after you meet any applicable TRICARE and MarineCARE deductibles. Cost shares for doctor visits? Co-pays for hospital stays? Cost shares for outpatient surgery? Cost shares for prescription drugs? MarineCARE can help pay for all of them.

Helps pay covered 'Excess Charges' For you

This can be a valuable benefit – especially if you see a civilian doctor who charges more than TRICARE allows. MarineCARE pays up to 115% of the TRICARE allowed amount of any excess charges. (Doctors and hospitals are prohibited from charging more than 115% of TRICARE allowed amounts … so MarineCARE covers up to this amount.)

Teams Up With TRICARE Prime

Now you can reduce out-of-pocket expenses by pairing TRICARE Prime with MarineCARE. First, MarineCARE covers your co-payments for any inpatient or outpatient care you get from a TRICARE Prime network provider. Then, if you see a TRICARE-approved civilian doctor without a referral from your Primary Care Manager (often called the TRICARE Point of Service Option) MarineCARE pays your cost-shares for inpatient and outpatient care after you meet the TRICARE Point of Service deductible. Plus, MarineCARE protects your savings by paying up to 115% of the TRICARE allowed amount for any "excess charges."

Coverage Continues for Your Family If Something Happens to You

You can rest assured that MarineCARE stands strong for your family – even if you can't be there yourself. If you pass away, your family's MarineCARE benefits can continue at NO COST to them for a full year.

7 MarineCARE Plans to Fit Your Family & Your Budget

Because Marine Corps families have different health care coverage needs, you can choose from 7 MarineCARE benefit options. Take a look:

RETIREE FAMILIES:

Inpatient Only Plan– Get most of your care at military hospitals? This plan helps protect against expensive care in a civilian hospital.

In/Outpatient Plan with $75 Deductible– Covered by TRICARE Standard? In/Outpatient Plans are the most popular way to guard against high medical bills.

In/Outpatient Plan with $150 Deductible– Valued coverage for families covered by TRICARE Standard.

In/Outpatient Plan with $250 Deductible– Affordable coverage for families covered by TRICARE Standard.

TRICARE Prime Supplement– Helps reduce out-of-pocket expenses for families covered by TRICARE Prime.

ACTIVE DUTY FAMILIES:

Inpatient Only Plan– Get most of your care at military hospitals? This plan helps protect against expensive care in a civilian hospital.

In/Outpatient Plan– Covered by TRICARE Standard? In/Outpatient Plans are the most popular way to guard against high medical bills.

 

 

BONUS BENEFIT: Drive Your Health Care Costs Lower With MCA TRICARE Gold

When you enroll in MCA&F's MarineCARE TRICARE Supplement Program, you can also lock in extra savings by activating the TRICARE Gold option. This special upgrade option helps you cut the costs of:

  • Dental visits (You'll save 20% - 50%!)
  • Orthodontics like braces
  • Chiropractic treatments
  • Vision care, eyeglasses & contact lenses
  • Diabetic supplies
  • And much more …

TRICARE Gold

Of course acceptance in TRICARE Gold is guaranteed. You cannot be turned down for this important upgrade. And best of all, one economical rate of just $5 a month covers your entire family!

TRICARE Gold is offered through Careington International Corporation. It is not insurance and is not arranged for, provided or underwritten by Hartford Life and Accident Insurance Company.

TRICARE Form Series includes SRP-1269, or state equivalent.

Rates

Group Rates make this coverage affordable

Even as costs for everything else go up every year, MCA&F has held down expenses to keep your MarineCARE rates steady for the past 7 years. Then MCA&F goes the extra mile by sending premium refund checks in years when MarineCARE benefits have a good claim experience.

MONTHLY RATES* FOR RETIREE IN/OUTPATIENT PLANS
Attained Age $75 Deductible $150 Deductible $250 Deductible
Member Spouse Member Spouse Member Spouse
Under 50  $36.26 $43.54 $25.47 $32.74 $15.26 $19.64
50 to 54  $50.60 $62.22 $39.81 $51.43 $23.85 $30.81
55 to 59  $64.87 $80.62 $54.07 $69.83 $32.42 $41.88
60 to 64  $80.81 $91.53 $70.02 $80.74 $41.97 $48.41
Each Child  $39.36 $25.98 $17.15

 

MONTHLY RATES* FOR RETIREE INPATIENT ONLY PLAN
Economical protection from Inpatient medical expenses
Attained Age Inpatient No Deductible
Member Spouse
Under 50 $9.35 $11.45
50 to 54 $13.85 $16.25
55 to 59 $22.18 $24.75
60 to 64 $29.58 $31.28
Each Child $6.93
MONTHLY RATES* FOR TRICARE PRIME SUPPLEMENT
Reduces out-of-pocket expenses for Retirees
Attained Age Member Spouse
Under 50 $7.97 $10.89
50 to 54 $12.17 $16.49
55 to 59 $16.79 $21.58
60 to 64 $19.28 $25.18
Each Child $11.19

 

 

MONTHLY RATES* FOR ACTIVE DUTY SUPPLEMENTS
For family members of Active Duty personnel
  Inpatient Only Plan In/Outpatient Plan
Spouse $1.44 $9.05
Each Child $0.58 $7.20

 

*You will be billed quarterly, and your premium notice will reflect an administration fee per household. Premiums are based on your age and increase when you reach the next higher
age category. You can never be singled out for a rate increase—rates can only be changed if they are changed for all persons within your age class. Rates and/or benefits may be
changed on a class basis. Coverage may not be available to residents of all states. The administration fee is based on billing preference. $3.00 regular billing, $2.00 credit card billing
and $1.00 ACH/PAC billing. Administration fee will be payable to the administrator.

 

Tricare Gold Discount Card**

Entire Household Rate = $5.00 per month

** This program is not insurance or a health insurance policy. It is a discount membership program offered by Careington International Corporation. Careington is not a licensed insurer, health maintenance organization, or other underwriter of health care services. This program is not provided by, arranged for, or underwritten by Hartford Life and Accident Insurance Company.

 

 

TRICARE Form Series includes SRP-1269, or state equivalent.

Why add MarineCARE if my family already uses TRICARE?

To reduce your family's out-of-pocket medical costs. As generous as TRICARE can be, it doesn't pay for everything. That's why a TRICARE supplement like MarineCARE is so important. MarineCARE helps protect your family budget by paying the covered expenses TRICARE leaves behind.

My family uses TRICARE Prime. What can MarineCARE do for us?

It can reduce medical bills from your family's budget. MarineCARE pairs up with TRICARE Prime to help cover your co-payments for any inpatient or outpatient care you get from a TRICARE Prime physician. Then MarineCARE gives you an extra layer of protection by taking care of any cost-shares you incur if you need to see a specialist or another doctor besides your Primary Care Manager. It's an important safety net for your family and your finances.

TRICARE Form Series includes SRP-1269, or state equivalent.

Terms

TRICARE

TRICARE means the Department of Defense regional managed care program for members of the uniformed services and their families, and survivors and retired members and their families. TRICARE provides CHAMPUS beneficiaries three choices for their health care delivery: TRICARE Standard, a fee for service option which is the same as standard CHAMPUS; TRICARE Extra, a preferred provider option which offers discounts; and TRICARE PRIME, an enrolled health maintenance organization (HMO) option.

Pre-Existing Condition Limitation

Any Injury or Sickness, whether diagnosed or undiagnosed, for which any person proposed for coverage has received medical treatment or care within the 12 months (6 months in California, Indiana, and Montana) immediately preceding their effective date will not be covered: (a) until that person (except in California, Indiana, and Montana) has not received medical treatment or care for that condition during a period of 12 consecutive months ending on or after his or her effective date; or (b) until the end of a 6-month period from the person's effective date in California or the end of a 12-month period from the person's effective date in Indiana and Montana. After 2 years (1 year in Indiana, Montana, North Carolina, and South Carolina; 6 months in California) from that person's effective date, he or she will become covered regardless of any pre-existing conditions he or she may have.

Effective date: You and your family will become covered effective on the first of the month following receipt of your signed enrollment form and premium payment.

Deferred Effective Date: If on the date that you are to become covered under the Policy you are confined in a Hospital, your coverage will be deferred until the first day after you are discharged.

Insured Person Termination: The Insured Person's coverage under the Policy will cease on the first to occur:

  1. 1. the date the Policy terminates;
  2. 2. the date the required premium is not paid, subject to the Grace Period provision;
  3. 3. the first premium due date on or next following the date he or she ceases to be a Member;
  4. 4. the first premium due date on or next following the date he or she ceases to be eligible for the Plan under which he or she is covered;
  5. 5. the date we or the Policyholder cancels coverage for a Class of Eligible Persons to which he or she belongs;
  6. 6. the first premium due date on or next following the date he or she becomes eligible for Medicare;
  7. 7. the first premium due date on or next following the date he or she attains age 65, unless he or she is not eligible for Medicare.
  8. Dependent Termination: The dependent's coverage under the Policy will cease on the first to occur of:
    1. a. the date the Policy terminates;
    2. b. the date the required premium is not paid, subject to the Grace Period provision;
    3. c. the first premium due date on or next following the date he or she ceases to be an Eligible Spouse or an Eligible Child;
    4. d. the first premium due date on or next following the date he or she ceases to be eligible for the Plan under which he or she is covered;
    5. e. the date we or the Policyholder cancels coverage for a Class of Eligible Person to which he or she belongs;
    6. f. the date the Member ceases to be covered, subject to the Covered Dependent Continuation provision; (This will not apply to the Spouse or Child of an Active Duty Member or a Service Disabled Member.)
    7. g. the first premium due date on or next following the date he or she becomes eligible for Medicare;
    8. h. if a spouse, the first premium due date on or next following the date he or she attains age 65 unless he or she is not eligible for Medicare;
    9. i. if a child, the date he or she attains age 21 or age 23 if he or she is enrolled full time at a school of higher learning.

Termination of a Covered Dependent's insurance will not prejudice any claim that occurred before the effective date of termination.

Confined or Confinement means being an Inpatient in a Hospital (or Skilled Nursing Facility) due to Sickness or Injury.

A Hospital or a Skilled Nursing Facility does not mean any institution or part thereof used principally as a rest home, a home for the aged, or a place for custodial care; or a place for the care of drug addicts, alcoholics, or the mentally ill.

Exclusions

This policy does not cover: injury or sickness resulting from war or act of war, whether war is declared or undeclared; intentionally self-inflicted injury; suicide or attempted suicide, whether sane or insane (in Missouri, while sane); routine physical exams and immunizations, except when: a) rendered to a child up to 6 years from his or her birth; or b) ordered by a Uniformed Service: (1) for a Covered Spouse or Child of an Active Duty Member; (2) for such spouse's or child's travel out of the United States due to the Member's assignment; domiciliary or custodial care; eye refractions and routine eye exams except when rendered to a child up to 6 years from his or her birth; eyeglasses and contact lenses; prosthetic devices, except those covered by TRICARE; cosmetic procedures, except those resulting from Sickness or Injury while a Covered Person; hearing aids; orthopedic footwear; care for the mentally incapacitated or physically handicapped if the care is required because of the mental incapacitation or physical handicap; or the care is received by an Active Duty Member's child who is covered by the "Program for the Handicapped" under TRICARE; drugs which do not require a prescription, except insulin; dental care unless such care is covered by TRICARE, and then only to the extent that TRICARE covers such care; any confinement, service, or supply that is not covered under TRICARE; Hospital nursery charges for a well newborn, except as specifically provided under TRICARE; any routine newborn care except Well Baby Care, as defined, for a child up to 6 years from his or her birth; expenses in excess of the TRICARE Cap; expenses which are paid in full by TRICARE; any portion thereof which is in excess of the Legal Limit; any expense or portion thereof applied to the TRICARE Outpatient Deductible; that part of any Covered Expense which is in excess of the TRICARE Allowed Amount, except as otherwise stated in the Supplement Benefits; treatment for the prevention or cure of alcoholism or drug addiction except as specifically provided under TRICARE and this Policy; any part of a covered expense which the Covered Person is not legally obligated to pay because of payment by a TRICARE alternative program. TRICARE Prime is not available in Florida.

Nervous, Mental, Emotional Disorder, Alcoholism, and Drug Addiction Limits:

The coverage provided under the Inpatient Benefits of the TRICARE Supplements for nervous, mental and emotional disorders, including alcoholism and drug addiction, is limited to: a) 30 Inpatient treatment days for a Covered Person age 19 or older; or b) 45 Inpatient treatment days for a Covered Person under age 19; per Calendar Year.

 

NOTE: This information 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 brochure 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 and Accident Insurance Company detail exclusions, limitations, reduction of benefits 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. AGIA, Inc. is the Plan Administrator and Insurance broker that administers the insurance plan on behalf of the Hartford Life and Accident Insurance Company for the benefit of the Group Policyholder. AGIA, Inc. is compensated for the placement of insurance and for the services it provides to customers on behalf of the insurance company, in addition to other compensation it may receive. This is a participating group policy under which dividends and/or experience credits may be paid to the Marine Corp Association.

 

Endorsed by: MCA&F

Underwritten by Hartford Life and Accident Insurance Company, Simsbury, CT 06089

The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company.

 

John B. Wigle, License No. 0482924

MCA&F Insurance Program Administered by:
A.G.I.A., Inc.
PO BOX 26610
Phoenix, AZ 85068

 

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Questions? Call MCA&F's Customer Service and Claims Phone number at 1 (888) 611-6010.

 

TRICARE Form Series includes SRP-1269, or state equivalent.

Download, print and mail in your Enrollment Form today!

  1. Use the link below to download and print the form.
  2. Please complete all fields on the Enrollment Form.
  3. Mail in your form to the MCA&F Group Benefit Program, P.O. Box 26610, Phoenix, AZ 85068-6610

 

Questions? Call MCA&F's Customer Service and Claims Phone number at 1 (888) 611-6010.

 

Download Printable Enrollment Form

TRICARE Form Series includes SRP-1269, or state equivalent.

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Activate Your MarineCARE Coverage Now

NO OBLIGATION WITH 30-DAY FREE LOOK

You're under no obligation today because you're fully backed by a 100% Satisfaction Guarantee.

Your official Certificate of Insurance outlines the full terms and conditions of MarineCARE. Take up to 30 days to look it over. If it's not what you had in mind, mail back the Certificate for a 100% refund; less any claims paid.

This product is not available in the following states: AZ, FL, GA, LA, ME, MD, MT, UT, VT.

 

Questions? Call MCA&F's Customer Service and Claims Phone number at 1 (888) 611-6010.