| Mon, Nov 11, 2013 @ 09:00 AM

How Do TRICARE® and Medicare Work Together?

Posted by Medicare Made Clear

tricare for lifeTRICARE® is the health care program that serves uniformed service members, retirees and their families worldwide.

Medicare is a federal health care program for U.S. citizens age 65 and older, under age 65 with certain disabilities and those who have end-stage renal disease.

You may be eligible for both TRICARE and Medicare. This article explains how the two can work together to help pay your health care costs.

Medicare Basics

Original Medicare consists of Medicare Part A and Medicare Part B. Medicare Part A provides hospital coverage. Medicare Part B provides coverage for doctor visits and outpatient care.

Medicare Part A is premium free for most people because they or their spouse paid Medicare taxes as an employee. Part B charges a monthly premium. Both parts charge additional costs such as deductibles, copays and coinsurance.

People who are getting social security or railroad retirement benefits when they become eligible for Medicare are enrolled in both Part A and Part B automatically, however, you may decide to refuse one or both. Others must sign up. You can sign up for Medicare at Medicare.gov or at your local social security office.

Most people accept or sign up for Part A because there is no premium. But some people choose to delay enrolling in Medicare Part B. This may make sense when you have other coverage, such as employer or union coverage. You can delay paying the Part B premium and use your other coverage for your medical care.

If you delay Part B, you can sign up when you leave or lose your employer coverage. Pay attention to timing, though, because you may be charged a penalty if you miss your enrollment window.

TRICARE For Life

TRICARE For Life is Medicare wraparound coverage for TRICARE beneficiaries. You are eligible for TRICARE For Life if you are entitled to Medicare Part A and have Medicare Part B, regardless of your age.

TRICARE For Life is available worldwide. It offers secondary coverage after Medicare in the U.S. and U.S. Territories. In other overseas locations, TRICARE For Life is the primary payer.

You must have both Medicare Part A and Medicare Part B to be eligible for TRICARE For Life. Based on your specific situation and needs, you may have other TRICARE options when you are Medicare eligible that may not require you to have Part B. For example, you may have coverage through a current employer that may allow you to delay signing up for Part B. However, you may lose eligibility for any TRICARE benefits if you do not have Medicare Part B when it is required. You can get more information about this in the TRICARE for Life Handbook.

TRICARE and Medicare Parts C and D

Medicare Part C is also called Medicare Advantage. Medicare Advantage plans are offered by private insurance companies approved by Medicare. Each plan must provide all the benefits of Medicare Parts A and B. Many plans offer additional coverage as well, such as vision and dental care. You may choose to receive your benefits through a Medicare Advantage plan or through Original Medicare, which is administered by the federal government.

TRICARE For Life may work with either a Medicare Advantage plan or Original Medicare. It’s important to understand the coverage and costs of any Medicare Advantage plan you are considering. Plans are offered regionally, and coverage and costs vary.

Medicare Part D is prescription drug coverage. Part D plans are also private plans offered by Medicare-approved insurance companies. The coverage is available in standalone Part D plans, or it may be included in a Medicare Advantage plan.

TRICARE For Life includes a prescription drug benefit, so you may not need a Part D plan. If you have TRICARE For Life and decide you want to enroll in a Part D plan, you can do it at any time. The TRICARE drug benefit is considered “creditable coverage,” which means it is at least as good as a Part D plan. This allows you to sign up without paying the Part D premium penalty that may apply if you did not have creditable drug coverage.

Get Help

You can contact your local State Health Insurance Assistance Program (SHIP) for free health insurance counseling and assistance. Visit Medicare.gov to find contact information for the SHIP office in your state.

For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, seven days a week.

Resources:

Medicare & You: Learn about Original Medicare coverage and costs.

TRICARE for Life Handbook: Get information about staying eligible, getting care and who to call for help.

TRICARE and Medicare Turning 65: Learn how Medicare may affect your TRICARE benefits.

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