As of 1/1/18, PGBA will not be accepting Other Health Insurance updates. Please contact the new TRICARE East Region contractor, Humana Military Services.
Below are some important things to remember about Other Health Insurance (OHI) when transitioning from Active Duty status. Active Duty refers to a person currently serving in the uniformed services.
When Active Duty Sponsors retire, their OHI becomes Primary to TRICARE® (as Active Duty their OHI was secondary to TRICARE). An Explanation of Benefits (EOB) from the primary OHI is required for any claims with dates of service after the retirement date.
When Reserve Component members transition out of Active Duty status, it is important that their OHI records are updated. While on active duty the family member’s OHI is primary to TRICARE, but the Sponsor’s OHI is secondary to TRICARE.
When Reservists switch to the Transitional Assistance Management Program (TAMP), TRICARE Reserve Select (TRS) or other programs, the Sponsor’s OHI is now considered to be Primary to TRICARE.
If there weren’t any OHI records on file at the time but are later identified, TRICARE is required to retroactively recoup the claims that should have been processed by the primary OHI. To avoid this happening to your claims, please make sure your OHI records are complete and accurate.