TRICARE, Medicare team up

Air Force News Service

FALLS CHURCH, Va. — TRICARE officials want beneficiaries who receive a disability check to ensure they are getting the TRICARE coverage they are entitled to receive.

In general, most beneficiaries become eligible for Medicare at age 65; however, many beneficiaries younger than 65 also qualify for Medicare and there is one critical fact they need to know.

“Most TRICARE beneficiaries who are eligible for premium-free Medicare Part A are required under federal law to enroll in Medicare Part B to keep TRICARE benefits,” said Anne Breslin, the TRICARE For Life program manager.

Medicare Part A covers inpatient care in hospitals and skilled-nursing facilities. It also covers hospice and some home health care.

Medicare Part B is medical insurance. It helps cover outpatient and physician services as well as some physical and occupational therapies and home health care. The Medicare Part B monthly premium currently is $96.40 and will remain the same for 2009. Individual premiums could be higher, based on income.

When Medicare coverage is effective, it becomes the primary insurance, while TRICARE becomes the secondary. Beneficiaries who take appropriate steps to maintain their TRICARE eligibility often will have no out-of-pocket expenses for health care services covered by Medicare and TRICARE.

Generally, beneficiaries who receive Social Security disability benefits begin receiving Medicare benefits after two years, and they may choose between options such as TRICARE Prime or TRICARE For Life. Most will need to have Medicare Part B, although there are some exceptions.

“Whatever they choose, we can’t emphasize enough that beneficiaries need to look carefully at their options before making decisions that could result in a loss of TRICARE coverage,” said Ms. Breslin.

Factors beneficiaries must take into consideration before making a decision when it comes to Medicare and TRICARE include: whether their spouse is on active duty; if they are disabled because of injuries suffered while serving on active duty; if they have other health insurance; or if they are enrolled in the Uniformed Services Family Health Plan or TRICARE Reserve Select.

Other factors also may apply, but help is available to understand the complexities of this benefit. Detailed information on how Medicare and TRICARE work together for eligible beneficiaries younger than 65 is available through the TRICARE Web site, where users can also download a new “Using TRICARE and Medicare” flier.

For more information, check the Medicare Web site or call (800) 633-4227; visit the Social Security Administration Web site or call (800) 772-1213; or call TRICARE for Life at (866) 773-0404.