How Does TRICARE Work with Medicare?

April 12, 2023

How Does TRICARE Work with Medicare?

TRICARE is a healthcare program that provides coverage to uniformed service members, retirees, and their families globally. On the other hand, Medicare is a government-run healthcare program that provides healthcare to US citizens aged 65 and above, citizens under 65 with certain disabilities, and citizens with end-stage renal disease. It is possible for some individuals to be eligible for both TRICARE and Medicare.

When you turn 65, you must enroll in Medicare to maintain your eligibility for TRICARE unless you meet certain criteria. Within 90 days of becoming Medicare-eligible, you must also change your TRICARE health plan. The health plan you choose will depend on your eligibility for Medicare, your active-duty status or that of your spouse, and your current TRICARE plan. To remain eligible for TRICARE, both parts of Original Medicare are required.

TRICARE for Life

TRICARE for Life is a secondary coverage plan that provides additional coverage to Medicare beneficiaries with both parts of Original Medicare. This coverage is automatic and available worldwide, with no enrollment fees required. TRICARE for Life becomes the primary insurance when you are outside of the US.

TRICARE for Life and Prescription Drug Plans

TRICARE for Life also offers prescription drug coverage, which is considered “creditable coverage”. This coverage is similar to Medicare Part D coverage. If you have a Medicare Part D prescription drug plan, you may still be eligible for TRICARE for Life, but it may be redundant.

TRICARE for Life, Medicare, and Health Care Costs

TRICARE for Life is always the secondary coverage plan to Medicare in the US, but it becomes the primary coverage plan when outside of the US. In the US, Medicare files a claim with the healthcare provider first. After Medicare has paid its portion, the remaining claim is sent to TRICARE for Life, which then pays its portion directly to the provider.

If you have any questions about your coverage, Seniorstar can help you with a free, no-obligation review of your Medicare needs. Contact us today for assistance.

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