TRICARE and Medicare Work Together for Eligible “Under 65” Beneficiaries

TRICARE and Medicare Work Together for Eligible “Under 65” Beneficiaries

FALLS CHURCH, Va. – TRICARE beneficiaries who receive a disability check – listen up. TRICARE officials want to ensure that beneficiaries receive the TRICARE coverage to which they are entitled.

In general, most beneficiaries become eligible for Medicare at age 65.  However, many beneficiaries under age 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, 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 is currently $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 will often 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 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 due to injuries 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 may also apply, but help is available to understand the complexities of this benefit.

Detailed information on how Medicare and TRICARE work together for eligible beneficiaries under 65 is available through the TRICARE Web site at http://www.tricare.mil/medicare, where users can also download a new “Using TRICARE and Medicare” flyer.

Additional resources for Medicare, TRICARE and Social Security information: FAQs at http://www.tricare.mil/faqs/ (select the TRICARE For Life category); visit http://www.medicare.gov or call 1-800-633-4227; visit http://www.ssa.gov or call 1-800-772-1213; or contact Wisconsin Physicians Service at 1-866-773-0404.

Visit the nearest ID card issuing facility or call 1-800-538-9552 for eligibility information.

About TRICARE Management Activity and the Military Health System
TRICARE Management Activity, the Defense Department activity that administers the health care plan for the uniformed services, retirees and their families, serves more than 9.2 million eligible beneficiaries worldwide in the Military Health System (MHS). The mission of the MHS is to enhance Department of Defense and national security by providing health support for the full range of military operations. The MHS provides quality medical care through a network of providers, military treatment facilities, medical clinics and dental clinics worldwide.  For more about the MHS go to www.health.mil.