How Tricare, Medicare work in retirement

Q: June, I am retired Army, have TRICARE Stan­dard and will be eli­gi­ble for Medicare in March of 2011. Do I need any addi­tional health care prod­ucts or will these do for a cou­ple who have sev­eral seri­ous health prob­lems?
Also do you know of any “retired” blogs where I could also go for information?

–David, Hen­rico, Va.

A: Med­ical cov­er­age dur­ing retire­ment is one of the great ben­e­fits of a mil­i­tary career! I have locked in my med­ical ben­e­fit and am as excited about that as I am the impend­ing pen­sion. So here’s how it all works. Once you’re eli­gi­ble for Medicare and sign up for Medicare Part B, your sec­ondary cov­er­age will be pro­vided TRICARE For Life (TFL). TFL is very sim­i­lar to a Medicare sup­ple­ment pol­icy. Check out the infor­ma­tion on the TRICARE web­site (includ­ing the hand­book and cost matrix). There are no enroll­ment fees (other than the Medicare Part B monthly pre­mi­ums) and the cov­er­age is com­pre­hen­sive. For Medicare and TRICARE cov­ered ser­vices, you’ll pay noth­ing out of pocket. To min­i­mize or elim­i­nate out-of-pocket costs, your provider must accept Medicare, so check with your doc­tor. You’ll also want to review the cov­er­age in the con­text of your health sit­u­a­tion to see if there are any holes. TFL will pro­vide the same cov­er­age as TRICARE Stan­dard if you’re over­seas (unlike Medicare which does not pro­vide cov­er­age out­side the U.S.). I would sus­pect you’re in pretty good shape when it comes to healthcare!

Regard­ing blogs directed to retirees, you can cer­tainly do an inter­net search and see what appeals to you. But let me pass along a few ideas. AARP pro­vides insight into retiree issues as do mil​i​tary​.com (of course!), VFW, Mil­i­tary Avenue, Mil​i​tary​Money​.com, the Mil­i­tary Wal­let and The Amer­i­can Legion. In fact you can find advice at The Legion from my col­league JJ Mon­ta­naro and me! Thank you for your service!

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29 responses to “How Tricare, Medicare work in retirement”

  1. Yes it’s gen­er­ally a good deal in the states but not so good over­seas where one gets to pay for medicare but gets none of the ben­e­fits. In addi­tion if one lives in the Philip­pines they will find the Tri­care Stan­dard has been reduced to a sec­ond class ben­e­fit with lim­ited access to providers. Very often retirees find they get to pay 100% of the cost of their care. On aver­age for inpa­tient care they can look for­ward to pay­ing 50% or more of the pro­fes­sional fees and even then they have to learn med­ical cod­ing and pro­ce­dures to con­vert local global bills into a form accept­able to TMA. Any­where else in the world they accept the local global bill and pay the full 75% they should. Local providers and hos­pi­tals tend to avoid Tri­care because of its bad rep­u­ta­tion and past actions. So also expect to keep $10,000 plus lay­ing around to pay for your hos­pi­tal­iza­tion up front and then hope to get 50% back.

    1. Does Tri­care pick up any of my pay­ments if I am in a nurs­ing home (I am now).

  2. I am retired Navy, have cov­er­age under my spouse, tri­care and VA do I loose my Tri­care if I do not take Medicare?

    1. What do you mean by cov­er­age under your spouse? Is she active duty? If so you will not need to enroll in B. But you may be subj to the pre­mium penatly for late enroll­ment (10% for each year you wait after becom­ing eli­gi­ble). con­tact medicare for more info on that.

      If she is not Active Duty and youare get­ting health insur­ance from her work, then you need B to keep tri­care elig. In this case you can do the fol­low­ing:
      1. Enroll in B (about $100/month) keep Tri­care and keep the work plan.
      2. Decline B and lose Tri­care eli­gi­bil­ity. When you later enroll in B, Tri­care eli­gi­b­lity will be rein­stated and you will be on TFL (Tri­care for Life).
      3. Enroll in B, keep Tri­care and drop work health plan. That may be more cost-effective if you are charged for your work plan.

  3. You must enroll in Medicare Part A and B to receive Tri­care For Life. Don’t dally. Accord­ing to medi​icare​.gov, the pre­mium for Part B goes up 10% for each 12-month period that you’re eli­gi­ble and don’t enroll.

  4. I am an Army retiree, and just enrolled in Medicare. I also cur­rently have TRICARE Prime for my spouse and me. Do I con­tinue pay­ing my TRICARE pre­mi­ums for myself?

  5. I am a spouse of a retired air­force and am 100% dis­abled with ms , i am now medicare eleg­i­ble after on dis­abil­ity for 2 years i am 49 years old. do i have to change my tri­care to select we have stan­dard , in addi­tion to medicare A& B at what cost

  6. I don’t trust Medicare. I had planned on keep­ing my NALC insur­ance and Tri­care stan­dard as sec­ondary but was told today that at 65 Tri­care stan­dard goes away and you are not able to keep it as a sec­ondary insur­ance. Is this true? I would pre­fer that to Medicare and TFL as I believe doc­tors and treat­ments or pro­ce­dures will lessen with Medicare and there will be many things then that TFL won’t cover. Rifht now I have nearly noth­ing in copays and out of pocket expenses and the EOB’s for both myself and hus­band have shown tremon­dous costs so far this year that we have not been respon­si­ble for. I would love to hear form some­one about the abil­ity to keep my pri­vate insur­ance and Tri­care Stan­dard after age 65.

  7. if a retired mil­i­tary per­son­nel needed Home­Health care who pays for it..Medicare or Tricare?

  8. I have Tri­care Stan­dard and need breast reduc­tion surgery to help with my back pain will Tri­care Stan­dard cover the cost?

  9. While I will reach 65 in March, my hus­band I are still work­ing and my hus­band has us cov­ered through a PPO which is pri­mary and Tri­care is sec­ondary. Will some­one please explain to me why I need to be enrolled in Medicare Part B?

    1. Nancy — you have options. To keep Tri­care eli­gi­bil­ity you must have part B Medicare once you are elig­ble for A. Since you are work­ing, you are able to enroll in B when you stop work­ing or lose your work health plan with­out the pre­mium penalty (non-working folks who do not enroll in B when first elig­ble see their pre­mi­ums go up 10% for each year they delay). You can do the fol­low­ing:
      1. Enroll in B (about $100/month) keep Tri­care and keep your work plan.
      2. Decline B and lose Tri­care eli­gi­bil­ity. When you stop work­ing you can enroll in B then and your Tri­care eli­gi­b­lity will be rein­stated and you will be on TFL (Tri­care for Life).
      3. Enroll in B now and drop work health plan. That may be more cost-effective if you are charged for your work plan.

      I work for DEERS.

      1. Jim — So to clear, I am work­ing and have a PPO that cov­ers my wife also who is not eli­gi­ble for Medicare. In order for me to keep Tri­care Stan­dard — Ret ben­e­fits I am required to enroll in Medicare Part B? — Mike

  10. I have Medicare and Tri­care For Life. Have had major back surgery in the past and still suf­fer some back pain. I have very large breasts and feel that they may be con­tribut­ing to and/or caus­ing the pain. Ques­tion: Will Medicare and Tri­care For Life pay for breast reduc­tion surgery?

  11. I am USAF Retiree, will turn 65 next month. Do I have to get a new ID card because of the expi­ra­tion date on the back of the card?

  12. Those retir­ing from from actve duty are eli­gi­ble for tri­care. How about vet­er­ans of the armed forces?

    1. If they did 20 years and retired from the armed forces then yes, they are eli­gi­ble for Tri­care. If it was under 20 years, then no, they will not receive Tri­care as it is a retire­ment ben­e­fit. How­ever, vet­er­ans are eli­gi­ble for med­ical care through VA centers.

  13. I am a sur­viv­ing spouse with Tri­care stan­dard. What will hap­pen to my cov­er­age when I am eli­gi­ble for Medicare?

  14. I have 2 homes and am a Nevada res­i­dent. I’ve heard oba­macare will force me to choose a hos­pi­tal near pri­mary res­i­dence I want to keep my cur­rent one out of area near other home. Will obcare make me pay for this. I ocare is scary as hell for me!!

  15. I must be For­rest Gump, I was under the impres­sion that I would have med­ical cov­er­age for the rest of my life because I am retired mil­i­tary. Now it seems like I have to get both part a & b medicare witch is another bur­den I will have to bare. Whats next?

    1. That’s in the reg­u­la­tion for TFL. Once you hit medicare age you have to pay a and B and Tri­care becomes your sec­ondary coverage…it’s still there just takes care of the bills that Medicare doesn’t

  16. I receive Tricare4Life, am 70 years old and recently broke my right hip. My hus­band is 72 and, although healthy enough, is not strong enough to take care of me at home and do all the house­work. I will be home­bound for sever weeks as my frac­ture heals. Can I receive ben­e­fits to employ a house­keeper once a week, to clean and change sheets?

  17. I will be 65 in March, have enrolled in Medicare Part A and B. As I under­stand it, I will con­tinue to have Tri­care that will pick up what Medicare does not pay. There­fore, I do Not need another sup­ple­men­tal insur­ance? But, I have to make sure I am enrolled in Tri­care for Life and DEERS info is updated to make sure pay­ments are cor­rect and on time? Is that right?

  18. Am going to be Medicare age in 10 months. Use a mil­i­tary facil­ity for all health needs. Also have Tri­care. Can I still use mil­i­tary facil­ity when I am forced on Medicare?

  19. Has any­one expe­ri­enced DEERS con­tin­u­ally stat­ing that you are enrolled in MEDICARE Part D, when you only have Parts A & B? It gets resolved, entered into the DEERS sys­tem as not hav­ing Part D and then in 30 days, DEERS says that I am enrolled in Part D. They can’t explain why it keeps chang­ing back.

  20. i am 62 and 100% dis­abled. i have insur­ance through my wifes work, also tri­care and va. i was noti­fied i have to sign up for medicare or loose tri­care. i dont need medicare until i reach 65 . medicare say i have to sigh up for part [a ] at this time! will there be a penalty if i do not sign up for part b medicare or can i wait until i am 65, since i dont need it and it would be a unnec­es­sart expence!

  21. It sounds as if your dis­abil­ity has made you eli­gi­ble for Medicare Part A. That being the case, you’ll actu­ally have to sign up for Medicare Part B to remain TRICARE-eligible. Here’s a link to some info at the TRICARE web­site:

  22. I live in Puerto Rico, I am 67 I have cov­er­age of Part A and B of Medicare. What ben­e­fits do I have of Tricare?

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