Multiple readers – Everywhere, USA: I receive a steady drumbeat of questions from military families about TRICARE, which covers nearly 9.5 million active and retired service members and their families. With the help of folks at TRICARE, here is a basic description of how it works and of where to find additional information.
Phil Moeller: First off, TRICARE morphs into TRICARE for Life for retirees. At this point, people need to have Medicare Parts A and B. TRICARE’s rules require it to send out alert postcards before TRICARE members turn 65, but of course these things do get lost in the mail. TRICARE members can get Medicare enrollment details and help at milConnect. TRICARE members also need to be registered with the Defense Enrollment Eligibility Reporting System (DEERS). As all readers of Ask Phil know, navigating Medicare’s various enrollment periods can challenge even the most proficient military obstacle course champion. There are penalties for late enrollment, but the biggest penalty may be unintentionally going without primary health insurance protection.
Getting Medicare and switching to TRICARE for Life means that Medicare then becomes the primary payer and TRICARE is secondary. Military folks often have second careers after leaving the service and may have another retiree health program besides TRICARE for Life. In this case, TRICARE for Life usually moves into the third-payer slot. Claims would flow to Medicare with unpaid amounts then flowing to the secondary insurer for payment. If a TRICARE for Life member then gets a request for payment, he or she can file a claim with the company that processes TRICARE for Life payments: Wisconsin Physicians Service – Military and Veterans Health (1-866-773-0404).
TRICARE for Life tends to have comparable, and usually cheaper, drug coverage than a Medicare Part D drug plan. As a secondary payer, it also usually provides coverage that is comparable to a Medigap policy. If anyone says a TRICARE for Life beneficiary needs either of these additional policies, I’d be initially skeptical. Look at the coverage terms of your policy, or get help from TRICARE or Wisconsin Physicians Service. You also can find free Medicare counseling help at the State Health Insurance Assistance Program (SHIP). However, TRICARE for Life users on very limited incomes might do better on a Part D plan because they could qualify for financial assistance from Medicare in paying for their Part D drugs and even for plan premiums and other expenses.