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How Does Medicare Work with TRICARE?

Veterans have several options when it comes to their Medicare health plan choices. Before enrolling, be sure to understand what kind of veteran benefits you have and know how they’ll coordinate care with the Medicare program.

Today, we will focus on how Medicare works with TRICARE for Life.

What Is TRICARE for Life?

TRICARE is the health insurance plan offered to active and retired military members, their spouses, and their dependents. It has comprehensive medical coverage and can be used worldwide. However, not every military veteran is eligible for TRICARE. Those who are not may qualify for other healthcare benefits.

When a TRICARE enrollee turns 65, they will need to enroll in Medicare Parts A and B. They can choose to delay their Part B enrollment if one of these three situations apply:

  1. They are on active duty.
  2. They are not on active duty but have other creditable coverage through a group health plan.
  3. They are enrolled in TRICARE Young Adult, TRICARE Reserve Select, or the US Family Health plan.

Delaying Part B under one of these circumstances will allow the member to postpone paying the Part B premium, and they will not incur any Medicare late enrollment penalties.

Once the member enrolls in Part B, their TRICARE coverage automatically turns into TRICARE for Life or TFL. When this happens, TFL becomes the secondary insurance payor. It acts similarly to a Medicare Supplement plan, which picks up costs that would otherwise remain from Parts A and B. This could include deductibles, copays, and coinsurance costs. In essence, TFL enrollees should have no out-of-pocket costs for medical treatment.

Do TRICARE for Life Members Need Medicare Part D?

Most veterans do not need to enroll in Medicare Part D, which is the part of Medicare that provides prescription drug coverage. Whether they are enrolled in TFL or have other VA medical benefits, most veterans receive their prescriptions through the VA system. 

If a veteran ever needed to enroll in Part D, their current prescription coverage would be deemed creditable, and no late-enrollment penalties would apply. In addition, they can enroll in Part D at any time of the year and can change their Part D plan during Medicare’s Annual Election Period (October 15 - December 7).

How Does TRICARE Work with Medicare Advantage?

While TFL members do not need to enroll in a Medicare Supplement plan, they may consider enrolling in a Medicare Advantage (Part C) plan

Medicare Advantage plans offer several benefits to veterans who have TRICARE for Life. First, many plans tailored to veterans offer a Part B giveback, which reduces the premium you pay for Medicare Part B. Second, Medicare Advantage plans provide several benefits not found in TFL.

TFL (and other VA benefits) does not include coverage for dental treatment and only offers limited coverage for vision and hearing services. Most Medicare Advantage plans have coverage for all three of these services. Since most MA plans come with a $0 premium, this is a great way to get extra benefits at no extra cost.

Lastly, Medicare Advantage plans contain many other bells and whistles. For example, they can include gym memberships, meal delivery, transportation, and even flex cards and over-the-counter (OTC) stipends.

If you enroll in a Medicare Advantage plan, the MA plan will become your primary insurance, and TFL acts as the secondary payor. Therefore, healthcare providers must be willing to send your medical claims to the MA carrier and TFL.

It’s important to understand that while TFL members don’t necessarily need to enroll in supplemental coverage, other military members who are not eligible for TFL should consider adding a Medicare Supplement plan or Medicare Advantage plan. Doing so would allow them to seek care outside the VA health system and cover more out-of-pocket costs.

To get more information on how Medicare works with TRICARE for Life, contact the experts at Local Medicare Specialists. We can review your current coverage and find out if you are eligible for any other Medicare health plans in your area.

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