Q. Does it make sense to select Humana's HMO over Medicare/Tricare for Life? Humana offers a rebate on Medicare Part B, health club, dental and vision. TFL doesn't. To me, Humana's plan looks pretty attractive, with more coverage. But one Humana rep asked me: "Why would you want to give up such an attractive plan as Medicare and TFL?"

Also, if I select the HMO and later decide I want Medicare/TFL, can I revert?

A. We get variations of this question all the time, and we just can't answer it definitively for the simple reason that everyone's health care needs, financial resources and life situation will be different. As such, there is no "right" answer.

As you note, a major shortfall of Medicare/Tricare is that neither covers routine hearing and vision tests, or hearing aids and eyeglasses, obviously among the most common health care needs of seniors. For that reason, many TFL beneficiaries look into Tricare supplemental policies offered by many military and veterans groups. To check into that, Google the words "Tricare supplemental insurance" and you'll get a bunch of hits.

If you're willing to pay the Medicare Part B monthly premium, currently a little over $100 a month for most beneficiaries, there is no reason you couldn't use both the Humana HMO and Tricare for Life. In that scenario, either the HMO or Medicare would pay first on any claims, the other would pay second, and the Tricare Standard portion of TFL would pay third.

On the timing issue: If you're no longer working when you become eligible for Medicare and don't enroll in Part B at that time, but decide you want to enroll later, you risk being hit with the Part B late enrollment penalty. This is equal to 10 percent of the Part B premium for each year that you could have signed up but chose not to.

There is no comparable financial penalty leveled by Tricare — you simply wouldn't be able to use the Tricare portion of TFL unless and until you enroll in Part B.

Q. My wife and I are both in our early 60s and retired. For years, we used my wife's Federal Employee Program Blue Cross-Blue Shield as our primary health insurance, with Tricare Standard as second payer. Over that time, we've never had to pay a co-pay — until now. This year, our regional Tricare contractor, UnitedHealthcare, says we are responsible for co-pays until we meet Tricare Standard's $150 deductible. Is this true or should I appeal their decision?

A. According to Tricare officials, UnitedHealthcare is correct. Each fiscal year, Tricare Standard beneficiaries must meet an outpatient deductible. For retirees, that is $150 per fiscal year for an individual and $300 for a family. When the contractor processes a claim involving other health insurance, it must perform many calculations and take into account various factors such as discounts, reasonable charge reductions, deductibles and cost-shares.

Depending on the amount paid by the OHI — your wife's federal employee coverage — it's possible the deductible had been met by what the OHI paid. But sometimes what the OHI pays may not be enough, and the beneficiary must pay out-of-pocket.

UnitedHealthcare should be able to explain to you in more detail how your deductible was calculated last year versus this year. You can reach UHC toll free at 877-988-9378.

Email questions to tricarehelp@militarytimes.com. Include "Tricare" in the subject line and do not attach files.

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