Tricare Help

Will patient lose Tricare after enrolling in long term care plan?

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I work for a Medicare Advantage plan, a special needs plan for people who live long term in a nursing home and have Medicare Parts A and B. We have someone who wants to enroll a parent who has Tricare. I know we work with Tricare, but wanted to check with you and make sure this person is not at risk for losing any benefits of any kind. Do you know if there is a scenario where it is possible that a Tricare member can be at risk when joining another plan?

I know of no way a Tricare beneficiary can lose Tricare eligibility by joining another plan.

One thing that must always be kept in mind, however, is that, by federal law, Tricare is always last payer to all other coverage. That is, claims must be filed with all other coverage first, and each plan must pay its maximum benefits before a Tricare claim may be filed.

For more information about Tricare and other coverage plans, please go to www.tricare.mil/claims or contact the Tricare Regional Managed Care Contractor at that link.

I’m about to get Tricare for Life; what else do I need?

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I am going to turn 65 in February. I am in the process of enrolling in Medicare Parts A and B. Besides Tricare for Life, do I need to buy other insurance, such as Medicare Part C? My husband is a military retiree.

Tricare for Life was designed especially for Tricare beneficiaries who become eligible for free Medicare Part A and are enrolled also in Medicare Part B. Those beneficiaries also retain their eligibility for all the benefits of Tricare Standard which, as second payer to Medicare, acts as a free Medicare supplement. If they are enrolled in Tricare Prime, it will be converted automatically to Tricare Standard on the date their Medicare coverage becomes effective.

TFL beneficiaries, therefore, are covered by two, full-service, stand-alone, health insurance plans, all for the cost of the monthly premium for Medicare Part B.

You should be cautious also of Medicare Part C, the Medicare Advantage plans. They are the original Medicare plan plus important medical services added by the commercial carriers of the Advantage plans. Advantage plans, however, are designed for civilians who do not have your free Medicare supplement. You should examine the Part C add-ons before buying to see which ones Tricare Standard automatically includes at no additional cost to you. With Tricare Standard, you do not need the Part C add-ons.

You also should not enroll in the Medicare Pharmacy Program, called Part D, because you, like all Tricare beneficiaries are automatically eligible for the free Tricare Pharmacy Program. The Defense Department’s Health Affairs office says, in effect, that you won’t benefit from Medicare Part D unless your income is so low that you qualify for financial aid to pay your Medicare Part B premiums.

Plus, enrollment in Part D will prevent your use of the Tricare Mail Order Pharmacy Plan, where the big savings come in. If you use the mail order plan, you can a 90-day supply of drugs for the same price that you would pay locally for a 30-day supply.

Do we also need Medicare Advantage Plan coverage?

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My wife and I have Tricare for Life and Medicare Parts A and B. I keep seeing commercials for Medicare Advantage Plans. Should we get one of those as a backup?

Don’t be seduced by ads for Medicare Advantage Plans. Those ads are written for civilians who don’t have two full-service insurance plans, as you and your wife have under TFL. Most of the extras, if not all of them, are yours through Tricare Standard which comes free with TFL. Under TFL, Tricare Standard acts as a free Medicare supplement.