Tricare is offered to active-duty military personnel, National Guard members, retirees, and their families. Tricare for Life is offered to retirees who are enrolled in Medicare Parts A & B and use Tricare as their secondary coverage to Medicare. Tricare for Life is offered to retired military members (typically those who served 20 or more years), their spouses, and dependents who also have Medicare Parts A & B.
When a Tricare recipient becomes qualified for Medicare, they are required to take both Medicare Parts A & B to remain using Tricare and shift to Tricare for Life. Medicare will be primary, and Tricare will be secondary. They can see that any provider who accepts Medicare and Medicare will forward the remaining claim amount to Tricare for their payment on the claim. They typically will not have out-of-pocket costs for services covered by Medicare and Tricare.
Typically, we do not recommend Tricare for Life beneficiaries to enroll in a Medicare Advantage Plan. Tricare for Life beneficiaries will already have creditable drug coverage, and it does not have a coverage gap. If one were to enroll in a Medicare Advantage Plan, it would make their Tricare for Life drug benefit secondary to the MAPD drug coverage, and it would replace original Medicare and be their primary coverage. The beneficiary would need to stay within the network of the MAPD, but with original Medicare, they can see any provider who accepts original Medicare. The MAPD plan would wipe out their Medicare and Tricare, and would not be beneficial to them.
They can, however, enroll in a stand-alone dental or vision plan to help fill in the gaps and gain extra coverage. They can purchase a Federal Employee Dental and Vision Insurance (FEDVIP) through the BENEFEDS website. There is an annual enrollment period, the Monday of the second full work week in November through the Monday of the second full work week in December.
A veteran can have Tricare for Life and be enrolled in VA benefits. The VA can bill Tricare for non-service-connected care received at the VA per VA guidelines.
- They can bill Tricare for a non-service-connected condition, but VA can’t bill Medicare.
- Tricare can only pay up to 20% of the Tricare allowable amount.
- The veteran will have to pay the remaining amount after Tricare pays.
- They can bill Tricare for a non-service-connected condition, but VA can’t bill Medicare.
- Tricare can only pay up to 20% of the Tricare allowable amount.
- The veteran will have to pay the remaining amount after Tricare pays.
Medicare enrollment periods do apply to Tricare for Life Members as well.
- https://tricare.mil/LifeEvents/Medicare/Retiree_and_Family
- https://www.ignitewithhumana.com/wp-content/uploads/2020/05/Humana-Veterans_One-Pager_FAQs_Hi-Res.pdf
- https://www.va.gov/resources/va-health-care-and-other-insurance
Thank you to our Veterans for your sacrifice and service! For more information, give Thompson Insurance a call (843) 369-5433!