TRICARE Toolkit: Navigating Federal Health Care Benefits

TRICARE Toolkit: Navigating Federal Health Care Benefits
Sturti/Getty Images

TRICARE-Toolkit-logo-draft.jpgMOAA’s TRICARE Toolkit provides insight and tips for navigating your TRICARE benefits. Have a question or suggestion for an upcoming column? Email beninfo@moaa.org. Read other TRICARE Toolkit columns at MOAA.org/tricaretoolkit.

 

Many military retirees take a position with the federal government as a post-military career choice. As federal civilian employees, they can choose health care options under the Federal Employees Health Benefits (FEHB) Program.

 

[JUNE 14 MOAA WEBINAR: 10 Tips for Finding a Federal Job]

 

Options include consumer-driven and high-deductible plans, health savings/reimbursable accounts, and fee-for-service plans.

 

MOAA members with complex FEHB Program issues should seek advice from the Office of Personnel Management (OPM), their human resources department, or an organization such as NARFE (National Active and Retired Federal Employees).

 

[RELATED: OPM on Health Care]

 

For those eligible to participate in both TRICARE or Medicare/TRICARE For Life (TFL) and FEHB programs, keep in mind that when a TRICARE beneficiary has other health insurance, by law, TRICARE pays only after all other health insurance, with limited exceptions.

 

While you’re working, under 65, and enrolled in FEHB, FEHB pays first and TRICARE second. While working at 65 or older and enrolled in FEHB, FEHB pays first, Medicare second, and TRICARE last.  After retiring from the federal government and over 65, Medicare pays first, FEHB pays next, and TFL pays last.

 

The majority of questions from military retirees and federal employees arise when they or their spouse are about to age out of TRICARE. Retirees have the option to cancel or suspend their FEHB benefit. Suspending allows the individual to reactivate coverage.

 

Cancellation after retirement ends the ability to enroll again. Here are the options most people choose.

 

[RELATED: MOAA's Federal Job Resources]

 

If working at age 65 and not covered by a spouse’s employer plan:

  • Maintain FEHB until getting ready to retire from federal service. This action incurs no Medicare premium penalty. If you’re not enrolled in Medicare, then you have no TFL.
  • Suspend FEHB, and enroll in Medicare Parts A and B and receive TFL.
  • Maintain FEHB, and enroll in Medicare/TFL.

 

If not working prior to age 65 or when approaching civilian retirement after age 65:

  • Maintain FEHB. Not enrolling in Medicare upon reaching age 65, in this case, will incur a future premium penalty (10% each year you’re not enrolled in Medicare) should the individual decide later to switch to Medicare/TFL.
  • Suspend FEHB, and enroll in Medicare/TFL.
  • Maintain FEHB, and enroll in Medicare/TFL.

 

[RELATED: FEHB Program Handbook]

 

Choosing the first or second options in both cases above can be based on premium costs for each program or not wanting to find new medical providers if yours do not accept Medicare.

 

MEDIPLUS® TRICARE Supplement 

Works hand-in-hand with your Select or Prime Plan. Count on valuable protection. 

Enroll Now

Related Content

About the Author

Capt. Paul J. Frost, AFC®, USN (Ret)
Capt. Paul J. Frost, AFC®, USN (Ret)

Frost co-leads MOAA's Financial and Benefits Education program and is also an accredited Veteran Service Officer (VSO), providing VA disability compensation claim and appeal information and advice to the military community.