Your guide for how TRICARE For Life and Medicare Advantage plans work together to cover the costs of veterans’ healthcare needs.
TRICARE (previously known as CHAMPUS) is a healthcare program available to active duty or retired service members, current or retired national guard/reserve members, and their beneficiaries. Unlike VA benefits, TRICARE is an insurance service contracted by the federal government. TRICARE may be used along with VA benefits and Medicare Advantage plans.
Below, we’ll outline how these services work together to cover your medical needs.
TRICARE and TRICARE For Life Benefits
Unlike VA benefits, which are provided by the government, TRICARE is an external insurance service.
The government contracts with network providers (such as Humana or Health Net Federal Services) to provide healthcare programs to those eligible.
TRICARE allows those enrolled to flexibly utilize military hospitals and clinics as well as civilian or “commercial” healthcare facilities.
For example, if you need specialty care and prefer to visit a military hospital, TRICARE covers this service.
However, TRICARE provides commercial options if you prefer to visit a specialist outside the military hospital or clinic.
TRICARE includes many types of plans, from TRICARE Plus to TRICARE Select, and others.
Here, we’ll focus on TRICARE For Life. TRICARE For Life (TFL) is considered a Medicare-wraparound supplemental coverage for those eligible for Medicare.
TRICARE For Life Enrollment
TRICARE For Life services are available worldwide, and your enrollment is not impacted by where you live. However, your health plan options may differ based on where you live.
Enrollment in TRICARE For Life isn’t necessary. Veterans enrolled in both Medicare Advantage Part A (hospital insurance) and Part B (medical insurance) are automatically enrolled in TRICARE For Life—and simply need to present their Medicare card and military ID at the time of service.
Those enrolled in TRICARE For Life are responsible for their Medicare Advantage Part B (medical insurance) premiums. The monthly premium of a Medicare Part B plan in 2023 is $164.90 (about $5 per month less than in 2022).
Veterans may also qualify for additional premium discounts.
Medicare Advantage Part D plans (prescriptions) are often not necessary because TRICARE For Life includes prescription coverage.
Additionally, TRICARE For Life is considered creditable coverage. This means that if you decide to enroll in Part D down the line, you will not face a penalty for not enrolling within the initial enrollment period.
Primary/Secondary Insurance and Costs
If you are enrolled in Medicare and TRICARE For Life, Medicare will be your primary insurance, and TRICARE For Life will be your secondary insurance.
If you carry supplemental insurance, Medicare will still be your primary insurance, your supplemental insurance will be considered your secondary insurance, and TRICARE For Life will be eligible costs at that point.
Some healthcare costs will be covered by both Medicare and TRICARE For Life. Some healthcare costs will be covered by neither.
Therefore, it’s important to discuss your medical needs with a licensed insurance agent so you understand your health plan options and payment responsibilities.
We typically do not recommend putting a Medicare Advantage plan in place if you have TRICARE benefits, as the two systems oftentimes do not work well together.
Veterans, we thank you for your service and look forward to helping you make your next healthcare and prescriptions coverage selections.
Please call our My Medicare Network office at (440) 793-7745 or fill out our contact form to get in touch with our licensed agents and learn which plans will work best for your needs.