Military Health, Tricare programs - Military Times

Tricare Help: Can I delay paying premiums?

Q. I have health insurance from my job, but I’m about to get Medicare. I must enroll in Part B to retain Tricare eligibility and get Tricare for Life, but I want to avoid the Part B premium until I retire from my civilian job. If I lose Tricare by not enrolling in Part B now, can I be sure my Tricare eligibility will be restored when I retire and enroll in Part B in three years? What effect will my loss of Tricare have on my wife’s eligibility?

A. Contact the Social Security Administration two or three months before your retirement date. You’ll need their help to coordinate the effective date of your Part B coverage with the end of coverage by your employer’s plan so that your coverage won’t lapse.

For reassurance that your Tricare eligibility has been restored when you enroll in Part B, call the Defense Eligibility Enrollment Reporting Service at (800) 538-9552. Your loss of Tricare eligibility will have no effect on your wife’s eligibility.

Q. I heard that when you get Tricare for Life, Tricare will pay for whatever Medicare does not. Does that include nursing home care, which Medicare does not cover?

A. For Tricare to pay for a service not covered by Medicare, the service must be covered by Tricare. Nursing home care generally is not covered.

Tricare for Life beneficiaries whose only health insurance is Medicare Part A and Part B plus Tricare Standard — the most common form of Tricare for Life — must get all their care from providers who will file a Medicare claim for the services they provide.

For every service on the Medicare claim that is covered by both Medicare and Tricare, Tricare will pay whatever Medicare did not. If the Medicare claim includes a service that is not a Tricare benefit, Tricare will pay nothing on that charge, and the patient will have to pay any Medicare co-payment and deductible.

Finally, if the Medicare claim includes a service that is covered by Tricare but not by Medicare, Medicare will deny payment, and Tricare will process that particular charge as if Tricare was the patient’s only health insurance.

Write to Hamby at Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@atpco.com. In youre-mail, include the word “Tricare” in the subject line and do not attach files. If using regular mail, please include an e-mail address for a faster response.