Q. I just turned 60, and I'm drawing reserve retirement pay. My question is this: I am already enrolled in Medicare Part A and B and am on Social Security. Can I be eligible for Tricare for Life, or do I still have to wait until I turn 65?
A. Since you are eligible for and enrolled in Medicare, you cannot use Tricare Prime. Your only option, in fact, is Tricare for Life. The TFL program consists of Medicare Part A (in-patient hospitalization coverage) and Part B (premium-based outpatient coverage) as the primary payer, with Tricare Standard as second payer. You must be enrolled in Medicare Part B and pay the required premiums to use Tricare for Life as your wrap-around coverage.
If your disabilities are related to service-connected health conditions, you also can be treated at any Veterans Affairs health facility for free. Be aware, however, that if you are seen at a VA facility for care not related to a service-connected disability, you may incur out-of-pocket costs since VA cannot accept payment from Medicare, and Tricare for Life cannot serve as primary insurer. Thus, if you are seen by a VA provider for a nonservice-connected condition, Tricare will pay only up to 20 percent of the Tricare "allowable charge" for these health visits, and the beneficiary would be required to pay the other 80 percent of the bill.
If you see a Medicare-certified physician, you typically will have zero out-of-pocket costs for health care services because the provider should be covered by both Medicare and Tricare.
Have a Tricare question? Email tricarehelp@militarytimes.com and include the word "Tricare" in the subject line. Do not attach files.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
