In the 1990s, the U.S. Department of Defense launched a healthcare program with benefits for active, retired members of the armed services, their dependent family members, and other select beneficiaries. The program offered three plan options known as TRICARE.
Over time, TRICARE has expanded to include more than a dozen different plans. The benefits are now suitable for members of the military and their dependents located around the world. All active duty and retired service members plus their dependents should have a clear understanding of what TRICARE is and how it works with Original Medicare to ensure coverage in all stages of life.
Types of TRICARE Insurance Policies
There are three types of TRICARE insurance policies available:
- TRICARE Prime Plans – All active-duty service members are required to sign up for a Prime plan. There are four different Prime plans, each specific to the location of enrolled service members. Prime plans offer the most comprehensive coverage and often allow coverage with no out-of-pocket expenses, but they require members to stick to a narrow provider network.
- TRICARE Select Plans – Retired service members and covered dependents can choose a Select plan instead of Prime. These plans offer greater choice in medical providers but come with more out-of-pocket expenses. Members may pay more enrollment fees, copays, deductibles, and other uncovered expenses.
- Specialized TRICARE Plans – There are some specialized plans designed to meet the unique needs of select categories of beneficiaries. TRICARE US Family offers elevated benefits for families in some regions of the United States. TRICARE Young Adult is for dependent children up to the age of 26. Other plans are designated for the National Guard/Reserves and their dependents.
What is TRICARE for Life?
TRICARE for Life is designed to work with Medicare. It serves as a secondary payment source, picking up charges that aren’t covered by Medicare. Expenses that would otherwise come out-of-pocket for Medicare beneficiaries are absorbed by this secondary insurance policy. In some cases, beneficiaries receive care with no out-of-pocket expenses due to TRICARE for Life.
Am I Eligible for Medicare and TRICARE for Life?
There are two ways to qualify for TRICARE for Life while receiving Medicare.
- Reach the age of 65 and enroll in Original Medicare, Parts A and B. Once enrolled, your TRICARE for Life benefits will automatically apply. This assumes you were covered by another TRICARE plan due to active or retired military or dependent status prior to turning 65 and becoming eligible for Medicare.
- Receive early eligibility for TRICARE for Life, based on a qualifying disability. Once you’re approved for early Medicare coverage due to disability and enroll in Parts A and B, you should also receive your TRICARE for Life coverage.
How TRICARE for Life Works with Original Medicare
If you live within the United States, your TRICARE for Life will serve as a secondary payment source only. When you receive medical care, your Medicare policy will pay up to the limits of your coverage first. The remaining charges will go to your TRICARE for Life policy, up to the limits of that policy.
You will only pay out-of-pocket healthcare charges if there are expenses not covered by Medicare or TRICARE for Life. In that case, you may receive a bill from your medical provider. For many, those uncovered expenses are limited due to the comprehensive coverage offered by TRICARE for Life.
How Does TRICARE for Life Work with Medicare Advantage Plans?
Once enrolled, your plan provider will send you a new insurance card. You present that new card to your medical provider when receiving care, storing the red, white, and blue Original Medicare card for later use.
Many beneficiaries prefer Medicare Advantage plans because they include all Original Medicare coverage plus some add-on benefits. For instance, many Advantage plans include prescription drug plans and/or coverage for dental, vision, and hearing services.
When you qualify for TRICARE for Life and sign up for a plan under Medicare Part C, it works much the same as TRICARE for Life plus Original Medicare. Your TRICARE plan will pick up any expenses not covered by your Advantage plan, up to plan limits.
How Does TRICARE for Life Work with Medicare Supplement Plans?
Medicare Supplement plans are designed to work with Original Medicare and require you to use the red, white, and blue Medicare card when seeking care from a medical provider. The plans are standardized by the federal government, so insurers cannot add benefits to compete with one another as they do with Medicare Part C plans.
Each Medicare Supplement plan is assigned a letter and each lettered plan offers a set benefits package. Insurance companies compete with their rates rather than with added benefits. Some plans are more comprehensive than others, giving beneficiaries a range of premiums.
When you qualify for TRICARE for Life and enroll in a Medicare Supplement plan, your TRICARE plan serves as a secondary payment source. Once your Original Medicare and Supplement plan have paid all covered charges, remaining charges are paid by TRICARE for Life, up to the limits of your plan.
How Does TRICARE for Life Work with Medicare Part D?
You shouldn’t need a Medicare Part D prescription drug plan if you also receive TRICARE for Life coverage. TRICARE for Life includes prescription drug coverage, and most beneficiaries don’t need additional coverage to meet their prescription needs.
If you need to contact a TRICARE representative, you should call the relevant TRICARE or TRICARE for life provider phone number. This list will serve as an easy way to send you in the right direction:
- TRICARE for Life – 1-866-773-0404
- TRICARE West Region – 1-844-866-9378
- TRICARE East Region – 1-800-444-5445