What TRICARE For Life Enrollees Should Know About Medicare Advantage Plans

What TRICARE For Life Enrollees Should Know About Medicare Advantage Plans
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(Updated Dec. 10)

 

As a Medicare/TRICARE For Life (TFL) enrollee, you get to choose which type of Medicare you want: Original Medicare Parts A and B or Medicare Advantage Plans Parts A and B. Original is the federal government insurance. Advantage is a commercial insurance company. Both act as your major medical coverage.

 

Medicare Advantage plans are all Medicare by law. The Advantage plans are also known as Medicare Part C.

 

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Medicare approves and contracts with insurance companies to offer Medicare Advantage plans. The Advantage plan becomes your Parts A and B Medicare coverage. Per Medicare law, the Advantage plans must be as good as — if not better than — the original Medicare Parts A and B.

 

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.

 

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The premium amount of the Advantage plans can vary, but many use your established Part B premium amount as their monthly premium cost. Your Part B premium will pay the insurance company rather than Medicare. Some plans’ premiums can be more than the Part B premium for the extra benefits provided. Advantage plans can provide extra insurance in the form of dental, vision, hearing, or health and wellness coverage. Some Advantage plans may have other costs beyond the premium like deductibles and copays, and some could cost less.

 

You must comparison shop to purchase an Advantage plan. Advantage plan availability varies by locale. The Advantage plan website allows you to customize features and cost. (You may find some added features are worth the extra cost.)

 

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Since TFL is your Medicare supplement, you do not need to shop for Medicare supplement insurance.

 

Beware: Many Advantage plans provide automatic drug coverage, also known as Part D. As TFL members, you probably won’t want another drug plan. Because TRICARE always pays last, you may find yourself filing manual claims to Express Scripts to exercise your TRICARE drug coverage. Plus, you will lose TRICARE home delivery by having another drug plan.

 

Download the Medicare and You handbook for details, or call (800) 633-4227.

 

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About the Author

Lt. Col. Shane Ostrom, USAF (Ret), CFP®
Lt. Col. Shane Ostrom, USAF (Ret), CFP®

Ostrom is MOAA's former Program Director, Financial & Benefits Education/Counseling