Tricare For Life: Medicare's Private Insurance Option

TRICARE For Life is a Medicare-wraparound coverage plan for those who are TRICARE-eligible and have Medicare Part A and B. It is not a standalone insurance plan, but rather a supplement to Medicare, which is a federal entitlement program. TRICARE For Life provides additional benefits on top of what is offered by Medicare Parts A and B, such as dental, prescriptions, and fitness. It is important to note that TRICARE For Life is not an insurance plan that can be purchased or enrolled in separately; it is only available to those who are already TRICARE-eligible and have Medicare.

Medicare Advantage plans

TRICARE for Life is Medicare-wraparound coverage for those who are TRICARE-eligible and have Medicare Parts A and B. Coverage is automatic if you have Medicare Part A and B, and is available worldwide. TRICARE is not an insurance plan as such, but rather a health care programme for uniformed service members, retirees, and their families.

Now, Medicare Advantage Plans, also known as Medicare Part C, are offered by private companies that contract with Medicare. These plans are a private insurance alternative to traditional Medicare, and are available to anyone with Part A and Part B. Medicare Advantage Plans are required to provide the same benefits as Part A and Part B, but they also typically include Part D prescription drug coverage, as well as some dental, hearing, and vision coverage.

There are several types of Medicare Advantage Plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Special Needs Plans (SNPs). These plans are offered by insurance companies that may decide to make them available to everyone with Medicare in a state, or only in certain counties. Each year, these companies can decide to join or leave Medicare, so there is a chance your plan could end coverage.

Medicare Part A

To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. To receive premium-free Part A, the worker must have a specified number of quarters of coverage (QCs) and file an application for Social Security or Railroad Retirement Board (RRB) benefits. The exact number of QCs required depends on whether the person is filing for Part A on the basis of age, disability, or End Stage Renal Disease (ESRD). QCs are earned through payment of payroll taxes under the Federal Insurance Contributions Act (FICA) during the person's working years.

People who must pay a premium for Part A do not automatically get Medicare when they turn 65. They must:

• File an application to enroll by contacting the Social Security Administration
• Enroll during a valid enrollment period
• Also enroll in or already have Part B

To keep premium Part A, the person must continue to pay all monthly premiums and stay enrolled in Part B. This means that the person must pay both the premium for Part B and the premium for Part A timely to keep this coverage.

TRICARE For Life (TFL) is Medicare-wraparound coverage if you are TRICARE-eligible and have Medicare Part A and B, regardless of age or place of residence. Coverage is only for those with Medicare and who are TRICARE-eligible. Coverage doesn’t extend to family members.

Medicare Part B

TRICARE For Life (TFL) is Medicare-wraparound coverage for those who are TRICARE-eligible and have Medicare Part A and B, regardless of age or place of residence. TFL coverage is automatic for those with Medicare Part A and B, with coverage starting on the first day that Medicare Part A and B come into effect.

When you use TRICARE For Life, you don't pay any enrollment fees, but you must pay Medicare Part B monthly premiums. Medicare Part B premiums for TRICARE For Life are based on your income. You can pay your Medicare Part B premiums online through Medicare Easy Pay, a free service that automatically deducts your premium payments from your savings or checking account each month. You can also pay by mail or credit card.

If you have other health insurance, such as a Medicare supplement or an employer-sponsored health plan, you can still use TRICARE For Life as long as you have both Medicare Parts A and B. In this case, Medicare pays first and the other insurance pays second.

Medicare Supplement Insurance

TRICARE for Life is Medicare-wraparound coverage for those who are TRICARE-eligible and have Medicare Parts A and B. It is not an insurance plan itself, but rather additional coverage for those who are already covered by Medicare.

Medigap policies can help cover costs such as deductibles, copayments, and coinsurance. For example, if you require inpatient hospital care, you will typically pay 20% of the Medicare-approved amount for most doctor services while hospitalised. With a Medigap policy, these costs may be covered, depending on the specific plan chosen.

Medigap policies can be purchased at any time during the year, but the best time to enrol is during the Open Enrollment period. This period begins on the first day of the month in which you turn 65 and are enrolled in Medicare Part B, lasting for six months.

It is worth noting that Medigap policies do not cover everything, and there may still be some out-of-pocket expenses. Additionally, Medigap policies do not cover prescription drug costs; for this, you would need Medicare Part D.

Medigap policies can provide peace of mind and help individuals manage their healthcare costs, ensuring they do not face unexpected financial burdens due to medical issues.

Medicare Part D

TRICARE for Life is Medicare-wraparound coverage for those who are TRICARE-eligible and have Medicare Part A and B, regardless of age or place of residence. Coverage is only for those with Medicare and does not extend to family members. TRICARE For Life is automatic if you have Medicare Part A and B, with coverage starting the first day that Medicare Parts A and B are in effect. You must pay Medicare Part B premiums.

If you decide to enroll in a Medicare prescription drug plan, TRICARE will pay second after Medicare. You can enroll during your Initial Enrollment Period or the annual Open Enrollment Period, which runs from October 15 to December 7, with prescription drug coverage beginning the next January 1.

If you have TRICARE and lose your coverage, you can enroll in Medicare Part D during the Open Enrollment Period. If you want to enroll outside of this period, you can do so through a special enrollment period, but Medicare may ask for proof that you had TRICARE coverage.

Frequently asked questions