TRICARE is fantastic coverage for retired military veterans. With all the parts of Medicare and TRICARE, it’s essential to understand how they work together and the available options. It’s also easy to wonder if supplemental insurance will get the most out of a person’s health care coverage.
TRICARE and Medicare are different. Medicare is a US health insurance program for Americans 65 or older who qualify. TRICARE is no-cost health insurance for US military retirees and their beneficiaries.
TRICARE and Medicare
When you have TRICARE coverage and turn 65, you’ll automatically be enrolled in Medicare Parts A and B.
Once you are on Medicare and TRICARE, Medicare becomes primary, and TRICARE will supplement Medicare. You must continue to pay your Part B premium to remain enrolled.
TRICARE will essentially work as a Medicare Supplement to pick up the portion of the Medicare cost-share you’d typically pay.
When used in concert, TRICARE and Medicare will cover most of your healthcare needs that are medically necessary. Unlike Medicare, TRICARE doesn’t typically issue an insurance card.
TRICARE coordination with Medicare Supplement plans
When you have TRICARE and Medicare, there isn’t really a need to enroll in a Medicare Supplement. Medigap plans only cover what Original Medicare doesn’t, and your TRICARE is picking up your Medicare cost-share.
If you enroll in a Medigap plan, expect TRICARE to pay last.
TRICARE Coverage for prescription drug
TRICARE has drug coverage built-in and is considered creditable drug coverage for Medicare. This means you don’t have to choose a Part D plan, and if you decide you want one later or lose TRICARE, you won’t be penalized.
TRICARE will send most of your medications through the mail. Still, you can also pick them up at your local Military base or VA hospital. There are many local pharmacies that you can use with TRICARE as well. With TRICARE, you’ll have a copay for some prescriptions.
TRICARE coordination with Medicare Advantage plans
It’s becoming increasingly common for TRICARE enrollees to enroll in a Medicare Advantage plan. While this isn’t needed, some TRICARE beneficiaries enroll to get the additional benefits Medicare doesn’t cover.
These items include gym memberships and additional dental, vision, and hearing coverage. Check the plan’s network to verify that your healthcare providers accept all your insurances.
In most cases, any covered services not paid for by the Medicare Advantage plan will receive coverage by TRICARE.
Different types of TRICARE
There are three types — TRICARE for Life, TRICARE Prime, and TRICARE plus.
TRICARE For Life is Medicare-enveloping coverage for its beneficiaries with Original Medicare. It doesn’t matter where you live or how old you are. You can receive medical care from any Medicare provider or use the coverage at a military hospital or clinic based on availability. You must pay Medicare Part B premiums, but enrollment isn’t required.
TRICARE Prime is an available managed care option, and TRICARE Prime is only available in Prime service areas worldwide. Active duty military must enroll in TRICARE Prime.
Family members can choose to enroll in TRICARE Prime or TRICARE Select. TRICARE Prime has fewer out-of-pocket costs than TRICARE Select but has fewer provider choices.
TRICARE Plus allows eligible beneficiaries to seek treatment at military treatment facilities that offer them. This is only for eligible beneficiaries not enrolled in TRICARE Prime or a Medicare Advantage HMO. There is no cost for primary care services.
It doesn’t cover specialist services at military treatment facilities or referrals outside the military treatment facilities. It doesn’t transfer to other military facilities.
TRICARE Eligibility and Marital Status
Single never married
You continue to be eligible for TRICARE Prime or Select past your 65th birthday if you are single or never married.
Married or divorced
Spouse 62 or older
If you’re eligible for premium-free Part A, you should sign up for Part B. TRICARE For Life coverage will begin on the same day you start Parts A and B.
Suppose you aren’t eligible to receive premium-free Part A under your spouse’s (or former spouse’s) Social Security number. You’d continue to be eligible for TRICARE Prime or TRICARE Select past your 65th birthday.
Spouse younger than age 62
You continue to be eligible for TRICARE Prime or TRICARE Select after your 65th birthday. You should apply for Medicare Part A under their Social Security three months before your spouse (or former spouse) turns 62.
Widows or widowers
If you’re eligible for premium-free Part A., Widows or widowers should also sign up for Part B. TRICARE For Life coverage will begin on the same day you start Parts A and B.
Suppose you’re not eligible for premium-free Part A. You’ll continue to be eligible for TRICARE Prime or TRICARE Select past your 65th birthday.
How much does TRICARE cost with Medicare?
TFL doesn’t have monthly enrollment fees; however, you must pay your Medicare Part B premium. TFL and Medicare work together to cover all your healthcare needs and costs.
Will I lose TRICARE once I turn 65?
No. Upon turning 65, it will become TRICARE for Life for most people.
Do you have to pay for Medicare if you have TRICARE?
Yes, you must continue paying your Medicare Part B.
Can I have TRICARE For Life without Medicare Part B?
No. You must enroll in Medicare Part A and Part B.
How does TRICARE work with Medicare?
Medicare pays first, and TFL will pick up your Medicare cost share.
Does TRICARE For Life cover the Medicare Part B deductible?
Unless you are on active duty, TRICARE for Life will cover your Medicare cost-share portions, including the Part B deductible. If you are on active duty, it will pay before Medicare.
Getting help with TRICARE For Life and Medicare
Although the combination of TRICARE and Medicare is strong coverage, it still might not cover every bit of cost incurred. That’s why figuring out if supplemental health insurance could fill any gaps is important.
We have licensed insurance agents who are experienced and can help explain your options in simple yet comprehensive terms to assist you in making the right decision regarding Medigap plans. The great part about utilizing our agents is it’s free of charge to you.
All you need to do is give us a call today or fill out our online request form to receive access to the best plans in your area.