If you're eligible for both TRICARE and Medicare, it's important to know how the two programs work together. In this video, we explain what you need to know about your coverage options.
Original Medicare consists of a few different Parts – A through D. But, how does each part work with TRICARE?
When TRICARE-eligible beneficiaries sign up for Medicare Part A and Part B, they automatically enroll in TRICARE For Life. In this case, Medicare works as primary insurance, and TRICARE For Life is secondary.
TRICARE For Life helps cover costs Medicare doesn't. These include: • Part A hospital deductible • Part B coinsurance
Some TRICARE For Life beneficiaries may enroll in a Medicare Advantage plan to access benefits such as gym memberships, dental, vision, and hearing. Original Medicare (Parts A and B) do not cover these costs.
If you choose to enroll in an Advantage plan, it will be primary and TRICARE for Life will be secondary. When receiving care outside of your Advantage network, TRICARE For Life will cover the costs that your plan doesn't pay for.
When you have TRICARE For Life, there's generally no need to enroll in a Part D prescription drug plan. TRICARE For Life includes a prescription drug program and there is no additional cost to you.
If you have TRICARE For Life and later enroll in a Part D prescription drug plan, don't worry about penalties. Tricare For Life is considered creditable coverage.
It's possible to also enroll in a Medigap plan when you have Original Medicare and TRICARE For Life. But, it's not necessary. In this case, Original Medicare will be primary, your Medicare Supplement plan will be secondary, and TRICARE For Life will pay last.
As for how TRICARE Prime works with Medicare, when you're under the age of 65 and you have Medicare with TRICARE Prime, you don't need to disenroll. TRICARE For Life isn't mandatory. Those with disabilities on Medicare can remain on TRICARE Prime as long as they're eligible. When you do qualify, you'll get a waiver of Prime enrollment fees or a refund for the past enrollment fee.
In another scenario, TRICARE Plus offers the same primary care access as TRICARE Prime. It works the same as regular TRICARE in regards to Medicare because it's still primary coverage. The military clinic or hospital doesn't cover costs or beneficiaries who receive care from non-military health facilities. Before scheduling an appointment, beneficiaries should contact their local military hospitals to make sure they accept TRICARE Plus because each facility decides whether they accept it.
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If you are a beneficiary eligible for both TRICARE and Medicare, it is important to know how the two medical programs work together. In today's video, we'll explain what you need to know about TRICARE and Medicare and how they work to understand your coverage options. Hello, Medicare Community. I'm Ashlee Zareczny, your Medicare expert for Elite Insurance Partners and MedicareFAQ.com. If you're familiar with Original Medicare, then you're aware it consists of a few different parts. You might be wondering how each part works with TRICARE. When you sign up for both Medicare Part A and Part B, TRICARE eligible beneficiaries will automatically be enrolled into TRICARE for Life. Medicare will work as your primary insurance and TRICARE for Life will be your secondary. TRICARE for Life will help cover costs for which Medicare does not cover. Such as, your Medicare Part A deductible as well as your Medicare Part B coinsurance. Some TRICARE for Life beneficiaries may choose to enroll in a Medicare Advantage plan to access benefits such as, gym memberships, dental, vision, and hearing as Medicare do not cover these costs. If you choose to enroll in a Medicare Advantage plan, your Medicare Advantage plan will be primary and your TRICARE for Life will be secondary. If you choose to receive care outside of your Medicare Advantage plans network, TRICARE for life will cover those costs that you would otherwise be responsible for. Thus the importance of ensuring your providers are in network before signing up for a Medicare Advantage plan because ultimately you may have no out-of-pocket cost once Tricare for life has paid there portion. When eligible for TRICARE for life there's generally no need to enroll in a Part D prescription drug plan. TRICARE for Life includes prescription drug coverage. Therefore, there is no additional cost to you. If you have TRICARE for life and later decide to enroll in a Part D prescription drug plan, don't worry about being penalized. TRICARE for Life is considered credible coverage. It's possible to also enroll in a Medicare Supplement plan when receiving both TRICARE for Life and Original Medicare, but it's not necessar. If you choose to enroll in Original Medicare, TRICARE for Life, and a Medicare Supplement Plan, Original Medicare will become your primary insurance, your Medicare Supplement policy will be your secondary insurance, and your TRICARE for Life will pay last. Now let's go over some other TRICARE scenarios and how they work with Medicare. In the first scenario, how does TRICARE Prime work with Medicare? If you're under the age of 65, when you have Medicare with TRICARE Prime, you don't need to disenroll. TRICARE for Life isnt mandatory. Those on Medicare because of disability can remain on TRICARE Prime as long as they're eligible. When you do qualify, you'll get a waiver of prime enrollment fees or a refund for the past enrollment fee. In our second scenario, let's go over how TRICARE Plus works with Medicare. When it comes to benefits, TRICARE Plus offers the same Primary Care access as TRICARE Prime. It works the same as regular TRICARE in regards to Medicare because it's still primary coverage. The military clinic or Hospital doesn't cover cost or beneficiaries, who receive care from non military health facilities. Before scheduling an appointment beneficiaries should contact their local military hospitals to make sure they accept TRICARE Plus as each hospital or clinic decides, if it accepts TRICARE Plus. Thank you so much for watching. I hope you found this video helpful. If you haven't already subscribed to our YouTube channel, make sure to do so. Don't forget to turn notifications on to be notified every time we upload a new video. We also have a fantastic Medicare community on Facebook. We will input a link in the description below so you can join. Until next time. Bye.