Editor’s Note: This article is part of MOAA’s 2026-27 TRICARE Guide, brought to you by MOAA Insurance Plans, administered by Association Member Benefits Advisors (AMBA). A version of the guide appeared in the November 2026 issue of Military Officer magazine.
What are Medicare Advantage plans (MAPs), and should you use one? Here are some basic details to help military beneficiaries decide:
Q. What are the plans?
A. MAPs are also called Medicare Part C. Private companies offer these alternatives to the federal government’s Original Medicare (OM) program. They include Part A for hospitalization, Part B for medical insurance, and sometimes Part D for pharmaceutical needs. MAPs must provide at least as much coverage as OM’s parts A and B, but they can offer more, such as basic dental and vision coverage, gym memberships, and discounted hearing aids. MAPs generally charge the same Part B premiums everyone pays, but some may offer a premium reduction (or giveback).
Q. Which medical providers accept MAPs?
A. Some MAPs have a specific network of providers. Other plans allow you to visit any Medicare-accepting provider. Make sure your preferred doctor will take your plan because once you enroll in a MAP, you are required to get all nonemergency health care from that plan’s provider network.
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Q. Are referrals or prior approval required?
A. Your MAP may require pre-authorization for certain health care services or equipment.
Q. Will my plan file claims with the TRICARE For Life (TFL) contractor?
A. Some plans have copayments or cost shares. If your MAP won’t file claims on your behalf, you may have to file paper claims with Wisconsin Physicians Service, the TFL contractor, for cost reimbursement.
Q. Do the plans offer prescription coverage?
A. If a MAP includes prescription drug coverage, then the TRICARE pharmacy benefit becomes secondary to your MAP. Until you exhaust your other insurance’s pharmacy benefit, you are prohibited from using the TRICARE Pharmacy Home Delivery program unless a drug is not covered by your other insurance plan (but is covered by TRICARE).
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Q. How do MAPS rate on the Medicare site?
A. Use the Medicare website to find and compare MAPs, physicians, hospitals, nursing homes, and other Medicare providers. MAPs are rated on a scale from one star to five, with the latter being the best.
Q. Do the plans include a return of premium or other financial incentives?
A. Some MAPs require you to pay a monthly premium in addition to your Medicare Part B premium. However, there are other plans that include a partial rebate on your premium or other financial incentives.
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