At age 65, it’s decision time: employer health plan and/or Medicare/TRICARE known as TRICARE For Life (TFL)? At age 65, TRICARE coverts to a Medicare supplement plan and TRICARE Prime and Select are not available.
TFL requires Medicare Parts A&B. Younger spouses continue under your employer health plan, stay under TRICARE Prime/Select, or stay with both until age 65.
Here are your options:
- A) You keep your employer plan while working and delay Medicare/TFL. You’re allowed to delay Part B while working and covered by an employer’s health plan. You temporarily lose TFL benefits until you enroll in Part B.
- B) Go with both the employer plan and Medicare/TFL. Enroll in Parts A/B Medicare, get your TFL benefits and have your employer’s plan. You’ll pay for all programs and you might be over insured.
- C) Go Medicare/TFL only. Check to see whether you can suspend your employer’s plan before you cancel it. Enroll in Medicare Parts A/B up to three months prior to age 65.
As long as you are working and covered by your employer’s plan, the employer’s plan pays first, Medicare second, and TRICARE third.
Once you stop working, the payment order is: Medicare pays first, then your employer’s plan, and finally TRICARE.
If you have TFL only, Medicare is the first payer, then TRICARE.
It’s best not to enroll in another drug plan. Another drug plan has to pay first, and you’ll be filing manual claims with TRICARE. In addition, another drug plan disqualifies you from the TRICARE Pharmacy Home Deliveryprogram.