Tricare offers outstanding medical coverage to military and military retiree families, but things can get a little confusing when the beneficiary reaches age 65. And if you're a family member trying to help an older relative with health-care issues, it can seem baffling.
Coverage under "regular" Tricare ends once the beneficiary becomes eligible for Medicare. For most people, that happens at age 65. In the three months before, during the month of or in the three months after you turn 65, you'll enroll in Medicare Parts A & B. Ideally, you will sign up for Medicare between one and four months before you turn 65, depending on your date of birth. This will ensure you have no gap in coverage. You can sign up online via the Social Security Administration, call the Social Security Administration or visit your Social Security office (but not during COVID rules).
If you miss the window to enroll in Medicare when you turn 65, you can sign up during the general enrollment period from January to March of each year. Your Tricare for Life coverage will be effective when your Medicare is effective.
Medicare Part A is free for eligible beneficiaries, but there will be a premium for Medicare Part B. The amount of the premium varies from year to year and may be based on your income.
When you switch to Medicare, you'll also switch to Tricare for Life coverage. Tricare for Life acts as a "wrap-around" policy to Medicare, much like a Tricare supplement wraps around Tricare health-care coverage. Medicare pays first, and then any remaining balance is submitted to Tricare for payment.
Coverage is automatic -- no enrollment forms! However, you may want to ensure that you show as Tricare-eligible within the Defense Enrollment Eligibility Reporting System (DEERS). Assuming you are properly listed in DEERS, your Tricare for Life effective date is the same date as your Medicare Part A and Part B effective date.
When using Medicare and Tricare for Life, you will present the provider with your Medicare identification card and your military identification card. There is no separate identification card for Tricare for Life.
If you are still working at age 65, you aren't required to enroll in Medicare Part B immediately under Medicare rules. However, you must purchase Part B to be covered by Tricare for Life. If you choose not to purchase Part B, you will not have Tricare for Life coverage until you purchase Part B coverage.
Tricare for Life pays after Medicare for medical care within the United States. For overseas care, Tricare for LIfe is the primary coverage, assuming you don't have a third policy. There are two contractors that handle Tricare for Life: Wisconsin Physician Services, for care provided in the U.S., and International SOS, for care provided outside the U.S.
Tricare for Life coverage is tied to the individual, so if you have other family members who are not using Medicare, they will keep their regular Tricare plan. If your move to Tricare for Life leaves just one family member using regular Tricare, their enrollment rate will move from the family rate to the individual rate.
Many people ask if they should maintain a third insurance coverage plan if they have Medicare and Tricare for Life. You should evaluate your individual situation, but in most cases, everything that is covered by the other insurance plan would be covered by Tricare for Life. Eliminating the other plan can create substantial savings in your overall health-care costs. However, you need to evaluate this decision carefully, as everyone has unique health-care concerns.
Tricare for Life extends the outstanding coverage of Tricare, even once Medicare becomes your primary health-care coverage. Understanding how they work, and work together, can ensure that you are receiving the full benefit of the two plans.