Tricare for Life (TFL)
and Medicare
Finding satisfactory healthcare coverage can be easier said than done. Thankfully, United States veterans and their dependents have options. At easyMed Insurance Services, we want to help you find the coverage that will help you continue to reach your health and financial goals. Medicare and Tricare for Life may be able to work together to expand your healthcare coverage while saving your wallet.
What is Tricare for Life?
You may have heard of Tricare prior to becoming eligible for Medicare. Tricare is a healthcare program managed by the Department of Defense that provides healthcare coverage for uniformed service members, retirees, dependents, and survivors. After turning 65 or becoming eligible for Medicare, you may find that you’re no longer eligible for your standard Tricare coverage.
Once you enroll in Medicare Parts A and B, you become eligible for Tricare for Life (TFL). Tricare for Life offers healthcare coverage that works with your Medicare plan. Also known as Medicare-wraparound coverage, this program acts as secondary coverage to Medicare.
Who is Eligible?
You are not required to enroll in Medicare Part B when you become eligible for Medicare, but you may need to if you plan on using Medicare and Tricare for Life together. Often, Tricare for Life eligibility depends on your Part B enrollment. Medicare Part B is required for:
- Retired service members
- Families of retired service members
- Medal of honor recipients or family members
- Survivors of a deceased spouse
- Eligible former spouses
Medicare Part B is not required if you are an active-duty service member or active-duty family member.
If you are enrolled in Medicare Parts A and B and Tricare eligible, you may be automatically enrolled in Tricare for Life. This coverage starts the day you enroll in Original Medicare (Parts A and B).
Original Medicare and Tricare for Life
Tricare for Life is wraparound coverage for Medicare. This means that you can be enrolled in both at the same time. Tricare for Life might not offer any additional benefits on top of your Original Medicare coverage, but it may help cover some out-of-pocket expenses.
Medicare will cover 80 percent of Part B covered services, leaving you to pay the remaining 20 percent coinsurance. If the service is also covered by Tricare, they may pay the remaining balance. It’s important to note that the Medicare Part B deductible is still your responsibility.
Many important healthcare services may not be covered by either Original Medicare or Tricare for Life, including some hearing, vision, experimental services, and more. Tricare does offer an option to enroll in a separate dental plan and vision plan.
Medicare Advantage and Tricare for Life
Medicare Advantage plans (Part C) are offered by private insurance companies. These plans include the same coverage as Original Medicare – often with additional benefits and potential savings. A Medicare Advantage plan may make managing your healthcare coverage and costs more convenient due to the ability to bundle coverage. Many Medicare Advantage plans offer vision, dental, hearing and prescription drug coverage in a single plan.
Medicare Advantage and Tricare for Life may work together to reduce your out-of-pocket costs and increase your benefits. Some plans offer a premium of $0. If you enroll in both Tricare for Life and a Medicare Advantage plan, TFL may act as a supplement and help pay for copayments.
Frequently Asked Questions
Whether you are enrolled in Original Medicare or a Medicare Advantage plan, Medicare will act as your primary insurance. Tricare for Life will act as your secondary and supplemental coverage. For example, your doctor will file a claim with Medicare, then Tricare for Life may help cover a portion of the remaining bill. There may be services that are not covered by Medicare or Tricare for Life.
After your doctor or hospital bill is submitted to Medicare, you may be left with a remaining balance. The remainder of your bill may be covered by your secondary insurance (or wraparound coverage). In this case, Tricare for Life acts as Medicare wraparound coverage.
There are no additional premiums involved with Tricare for Life. You are still responsible for your Medicare Part B monthly premium.
If you have Tricare for Life, you can get care from any authorized provider. If Medicare is your primary insurer, find a provider that accepts Medicare. Many If you have a Medicare Advantage plan, you may be limited to plans in your network.
Enrollment Eligibility
Annual Enrollment Period (AEP)
Medicare Annual Enrollment Period runs each year from October 15 to December 7. What is the Annual Enrollment Period vs. Open Enrollment Period?
Initial Enrollment Period (IEP)
Your Initial Enrollment Period generally surrounds your 65th birthday but may occur if you otherwise become eligible for Medicare for the first time.
Special Enrollment Period (SEP)
You may be eligible if you experience a qualifying life event such as moving to a new zip code, losing employer coverage, or change in Medicaid status.
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Further Reading:
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Last Updated: October 13, 2023 MULTIPLAN_ETQEZMwebsite_2024_M