Did You Know: TriCare & Medicare
What is TriCare for Life (TFL)?
TriCare is a healthcare program of the US Department of Defense for active and retired uniformed service members and their families.
How does it work with Original Medicare?
If you’re eligible for TriCare and have Medicare Part A and Part B, TriCare for Life provides wraparound coverage which pays your out-of-pocket costs in Original Medicare for TriCare covered services. Medicare and TriCare coordinate benefits which eliminates the need for you to file claims.
How does it work with a Medicare Advantage plan?
If you enroll in a Medicare Advantage plan, you’ll have to pay copayments at the time of service. TriCare for Life can reimburse you for copayments you paid for TriCare covered services, when you file a paper claim.
Beware: Many Advantage plans provide automatic drug coverage, also known as Part D. TFL members probably won't want another drug plan. Because Tricare always pays last, you may find yourself filing manual claims to Express Scripts to exercise your Tricare drug coverage. Plus, you will lose Tricare home delivery by having another drug plan.
Finding a Provider
You may get health care services from Medicare participating and Medicare non-participating providers, as well as from providers who have opted out of Medicare. If TriCare for Life (TFL) is the primary payer, you must visit TriCare authorized providers and facilities. You’ll have significant out-of-pocket expenses when you get care from opt-out providers, or when seeing a U.S. Department of Veterans Affairs (VA) provider for health care not related to a service-connected injury or illness. Costs vary according to the type of provider you see (for example, opt-out or VA).