Tricare For Life: Primary Insurance With Medicare As Secondary

TRICARE is a healthcare program that serves uniformed service members, retirees, and their families worldwide. Medicare, on the other hand, is a federal health care program for US citizens aged 65 and older, as well as those under 65 with certain disabilities or end-stage renal disease. If you have TRICARE and become eligible for Medicare, you need to enroll in Medicare to maintain your TRICARE eligibility. TRICARE For Life (TFL) is Medicare-wraparound coverage for those who are TRICARE-eligible and have Medicare Parts A and B. TFL is automatic for those with Medicare Parts A and B and there is no enrollment fee. So, is TRICARE For Life your primary insurance with Medicare secondary? The answer is, it depends. In the US and US Territories, Medicare is the primary payer, but in other overseas locations, TRICARE For Life is the primary payer.

TRICARE For Life is Medicare wraparound coverage

TRICARE is a healthcare program that serves uniformed service members, retirees, and their families worldwide. TRICARE For Life (TFL) is Medicare-wraparound coverage for those who are TRICARE-eligible and have Medicare Part A and B. This means that if you are eligible for TRICARE and have Medicare Part A and B, you are also covered by TRICARE For Life.

TFL coverage is automatic if you have Medicare Part A and B, and there is no additional fee for enrolling in TFL. TFL is available worldwide, and you can visit any authorized provider. To prove your coverage, all you need is your Medicare card and military ID.

In the U.S. and U.S. Territories, Medicare is the primary payer, and TRICARE For Life is secondary coverage. Your provider will first file the claim(s) with Medicare, which will pay its portion and then send the claim to the TFL claims processor. TFL will then pay its portion directly to the provider for the services it covers. Generally, you will have no out-of-pocket costs for services that both Medicare and TRICARE cover. However, you will have out-of-pocket costs for care that isn't covered by either Medicare or TRICARE.

When using TRICARE For Life in overseas locations, TRICARE becomes the primary payer, and you are responsible for paying TRICARE's annual deductible and cost shares.

If you have other health insurance in addition to TRICARE, such as a Medicare supplement or an employer-sponsored health plan, you can still use TRICARE For Life as long as you also have both Medicare Parts A and B. In this case, Medicare will pay second, after your other health insurance.

TRICARE For Life is available worldwide

TRICARE For Life (TFL) is available worldwide. It is Medicare-wraparound coverage for TRICARE-eligible beneficiaries who 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.

TFL enrolment is not required and is automatic if you have Medicare Part A and B. Coverage starts the first day that Medicare Part A and B are in effect. You must pay Medicare Part B premiums, but there are no TFL enrolment fees.

When using TFL in all overseas locations, whether you live overseas or are travelling, TRICARE is the primary payer and you are responsible for paying TRICARE's annual deductible and cost shares.

If you live overseas, you must have Part B to remain eligible for TRICARE, even though Medicare doesn't provide coverage overseas.

If you have other health insurance, such as a Medicare supplement or an employer-sponsored health plan, you can use TRICARE For Life as long as you have both Medicare Parts A and B.

Medicare is the primary payer in the US and US Territories

Medicare is the primary payer for those enrolled in TRICARE For Life (TFL) and living in the US and its territories. 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.

Medicare is the primary payer, and TRICARE is the secondary payer for TFL. This means that Medicare pays first, and TRICARE pays some of what's left. In most cases, your provider will file your claims with Medicare. Medicare pays its portion first and sends the claim to the TFL claims processor. TFL then pays the provider directly for TRICARE-covered services.

Medicare is the primary payer for Medicare-covered services, and TRICARE will pay the coinsurance amount. TRICARE is the primary payer for services not covered by Medicare.

Medicare provides coverage in the US and US Territories. When using TFL in all overseas locations, TRICARE is the primary payer, and you're responsible for paying TRICARE's annual deductible and cost shares.

TRICARE For Life is the primary payer overseas

TRICARE For Life is Medicare-wraparound coverage for those who are TRICARE-eligible and have Medicare Part A and B. This coverage is available worldwide, regardless of age or place of residence. However, Medicare does not provide coverage outside the United States or U.S. territories. Therefore, when using TRICARE For Life in all overseas locations, TRICARE becomes the primary payer.

If you live overseas or are travelling, TRICARE is the primary payer, and you are responsible for paying TRICARE's annual deductible and cost shares. You must have Medicare Part B to remain eligible for TRICARE, even though Medicare does not provide coverage overseas.

International SOS is the TRICARE Overseas Program contractor and will provide assistance with claims, finding a provider, and authorisation, among other services.

If you have other health insurance in addition to TRICARE, such as a private insurance program or employer-sponsored health insurance, TRICARE pays last, after Medicare and your other health insurance.

TRICARE For Life includes a prescription drug benefit

TRICARE For Life (TFL) is a Medicare-wraparound coverage option for those who are TRICARE-eligible and have Medicare Parts A and B. It is not an insurance plan in itself, but rather a supplement to Medicare, and it does not extend to family members. TFL coverage is automatic and worldwide if you have Medicare Parts A and B, and there is no additional enrollment fee. However, you must pay Medicare Part B premiums, which are based on your income.

TFL includes a prescription drug benefit under the TRICARE Pharmacy Program. This means that if you are retired and enrolled in TFL, you automatically get prescription drug coverage at no additional cost. TRICARE covers most prescription drugs approved by the Food and Drug Administration (FDA), and these drugs may be covered under the pharmacy benefit or the medical benefit. The TRICARE Formulary is a list of generic and brand-name prescription drugs that are covered. TRICARE also offers separate pharmacy coverage for those using the US Family Health Plan.

The prescription drugs covered by TRICARE fall into four categories: generic formulary drugs, brand-name formulary drugs, non-formulary drugs, and specialty drugs. The costs vary depending on the drug category and the type of pharmacy. At a military pharmacy, you can usually get a 90-day supply for free. At a retail in-network pharmacy, you will typically pay $16 for a 30-day supply of generic drugs, $48 for brand-name drugs, or $85 for non-formulary drugs. If you choose home delivery, you can get a 90-day supply of generic drugs for $14, brand-name drugs for $44, or non-formulary drugs for $85.

It is important to note that TRICARE pays after all other health insurance, except in specific cases such as State Victims of Crime Compensation Programs and other Federal Government Programs identified by the Director of the Defense Health Agency. Therefore, if you have other health insurance with prescription drug coverage, your plan pays first, and TRICARE pays second at the pharmacy.

Frequently asked questions