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Skilled Nursing Facility Benefits
TRICARE For Life requires authorization for Skilled Nursing Facility (SNF) care once TRICARE becomes the primary payer. By law TRICARE is the last payer after all other insurance or benefit plans, to include Medicare. Absent other health insurance coverage or upon Medicare coverage exhausting, TRICARE becomes primary payer on day 101 of the inpatient SNF stay. In order to avoid continued coverage issues or payment penalties it is advisable to submit your authorization request with supporting documentation on day 90 of the inpatient stay.
WPS provides a wealth of information on the Skilled Nursing Facility benefits available to TRICARE For Life patients on our beneficiary portal including coverage, guidelines, and authorization requirements that will be helpful for you. Our goal is to help you better understand expectations and policies under the TFL program.