(Updated Dec. 10, 2020)
If MOAA members’ calls and emails to our finance and benefits information team are any indication, their top four most confounding issues are transitioning to Medicare/TRICARE For Life; navigating TRICARE after retiring from the service; working past the age of 65; and what to do about your children’s health care after they age out of TRICARE.
Here’s some additional information about each topic that might help you.
Transitioning to Medicare/TRICARE for Life
By law, TRICARE Prime and Select stop at age 65, and Medicare/TRICARE for Life takes over. The realization of what this means doesn’t hit most people until they are enrolling in Medicare Parts A & B.
TRICARE recipients aren’t accustomed to monthly premiums, and Medicare Part B has a monthly premium, which is based on your income. For some, the premium can be expensive, ranging from $135 to $460 a month a person.
Also, TRICARE stops being a major medical plan at age 65. It morphs into TRICARE for Life, a Medicare supplement. To be a “supplement,” it has to supplement Medicare Parts A & B. If you don’t receive Medicare Parts A & B, then you won’t be able to qualify for TRICARE For Life. And if you have TRICARE For Life, you can disregard all of those Medicare supplement solicitations you’ll receive.
Here’s one final shocker. Medicare comes in two versions: Original Medicare and Medicare Advantage (aka Part C). It’s your choice. Original Medicare is federal government coverage. Medicare Advantage is coverage by a health care insurance firm. Both count as Parts A & B Medicare because they are Parts A & B Medicare. Advantage plans must provide as much coverage as federal government Medicare by law, but they can provide more coverage.
Technically, TFL supplements Advantage plans as it does Original Medicare since all are Parts A and B Medicare. However, TFL does not link with an Advantage plan in-system as Original Medicare does. This means claims will not flow automatically and seamlessly through the computer from Advantage plan to TFL as they do with Original Medicare.
You will probably have to file manual claims to TFL to have expenses that fall out of the Advantage plan reimbursed. You can call TFL to determine if coordination between TFL and an Advantage plan is possible by calling TFL at (866) 773-0404.
Do not get Medicare Part D, pharmacy. Some Advantage plans come with a pharmacy plan automatically, so be careful; it will mess with your TRICARE pharmacy plan.
Navigating TRICARE After Service Retirement
You’ll have to choose a TRICARE plan — TRICARE Prime or Select — after you leave the service. Or you can choose a health plan offered by your new employer. Or you can have a combo platter of the employer plan and a TRICARE plan. When you throw in the Health Savings Account (HSA), that can be a bridge too far!
Health care plans come in different forms: PPO, HMO, or HSA. However, if you have more than one plan, it can get messy. We do not suggest you have multiple plans. (Technically, members with TRICARE cannot have a HSA.)
For further reading on health care plans, search for details about PPOs, HMOs, or HSAs on our website or the greater interwebs.
Working After Age 65
Just because you turn 65 doesn’t mean you’re ready to be put out to pasture. Do you have to enroll in Medicare if you are still working? No.
If you’re covered by your employer’s healthcare plan as you continue to work, you can delay Medicare enrollment. You have eight months from the end of your employer’s plan or your retirement date, whichever comes first, to enroll in Medicare. Enroll early to prevent a gap in coverage.
Employer retiree health care plans don’t count. You have to be working and carry the employer plan, and the employer must have 20 or more employees to delay Medicare enrollment.
[RELATED: MOAA Answers More of Your Health Care Transition Questions]
Remember: If you don’t have Medicare Parts A & B, you can’t have TRICARE for Life. And you cannot continue your TRICARE Prime or Select past age 64. (Yes, TRICARE for Life allows a delay as the Medicare does.)
Children Aging Out of TRICARE
Dependent kids age out of TRICARE at age 21, or 23 if they are enrolled in college. Here are your options if you want them covered for a longer period of time.
- TRICARE Young Adult covers children until they turn age 26. Check it out online. Hold on to your bottom when you see the monthly premium amount.
- Check your employer’s health care coverage for their rules on children.
- Check with the college health services’ office for student coverage.
- Go to ehealthinsurance.com and search for various forms of coverage for kids. Consider catastrophic coverage or a high deductible plan if your child is healthy.