| |
NOTE: To pay premiums semi-annually or annually, just multiply
your quarterly
premium by 2 or 4 respectively.
| USBA Tricare
Supplements Economical Rates |
| Military Retirees |
High Option II Plan
|
Comprehensive
|
| Retiree or Spouse |
Month |
Quarter |
Month |
Quarter |
| Under 40 |
$18.33 |
$55.00 |
$30.67 |
$92.00 |
| 40-44 |
$19.67 |
$59.00 |
$33.33 |
$100.00 |
| 45-49 |
$22.67 |
$68.00 |
$35.67 |
$107.00 |
| 50-54 |
$29.33 |
$88.00 |
$44.67 |
$134.00 |
| 55-59 |
$34.67 |
$104.00 |
$52.33 |
$157.00 |
| 60-64 |
$42.00 |
$126.00 |
$65.00 |
$195.00 |
| Each Child of Retiree |
$14.33 |
$43.00 |
$22.67 |
$68.00 |
| Active Duty Family Plan |
| Spouse |
$7.00 |
$21.00 |
N/A |
N/A |
| Each Child |
$6.00 |
$18.00 |
N/A |
N/A |
Premiums shown are PER PERSON. Premiums increase based on your effective
date of coverage and as you move from one age bracket to another.
The insurance company reserves the right to change benefits or premiums
on a group wide basis. NOTE: To pay premiums semi-annually or annually,
just multiply your quarterly premium by 2 or 4 respectively.
Economical Quarterly Premiums to fit your budget - As a member,
you benefit from our mass purchasing power, making the rates for
this valuable coverage surprisingly affordable. What's more... the
insurance company guarantees you'll never be singled out for a rate
increase, no matter how many claims you file!
*Newborn children not named in your enrollment form are automatically
covered from birth for injury or sickness, including treatment of
congenital defects and birth abnormalities, for 31 days. You must
notify the Plan Administrator in writing and pay the additional
premium due within 31 days of birth for coverage to continue beyond
this period. Insured children who are incapable of self-sustaining
employment because of mental retardation or physical disability-
and who are unmarried and chiefly dependent child's on the insurance
terminates on the premium due date following the date he or she
is no longer a dependent.
Select and Download the Plan Application that's right for you:
Members of NGAUS or EANGUS
Members of the National Guard not affiliated with NGAUS or EANGUS
Members of the Reserve
All Others
Download Claim Form
|
 |
|
All plan information can be downloaded and saved in PDF format readable by Adobe Acrobat Reader. If you do not have Acrobat Reader, you may download it from the Adobe web site.
|
|
Clicking on "Print this plan" takes you to a printer friendly version of the page. Printer friendly plans include plan rate tables.
|
|
Click here to order your free, no-obligation Info Packet and we will rush it to you. |
|
We're happy to help! Call us at 1-800-368-7021 from 8:00 a.m. - 4:30 p.m. Central time for live assistance (or leave a message after hours for prompt callback). You can also email us at usbainfo@usba.com.
Send comment about the web site contact: webmaster@usba.com.
|
|
