From TRICARE Standard to TRICARE for Life

             
Making the Transition When You Become Medicare-Eligible
If you become eligible for Medicare at age 65 or become entitled to Medicare because of a disability or end-stage renal disease, your TRICARE coverage will change.

When you are eligible for TRICARE and have Medicare Part A and Medicare Part B, you are covered by TRICARE For Life (TFL). TFL pays second to Medicare for all services covered by both Medicare and TRICARE.

There’s no enrollment application for TFL, but you do have to follow certain steps to make sure you remain TRICARE-eligible when you become eligible for Medicare. This will ease your transition from TRICARE Standard to TFL.

Verify your Medicare eligibility and enroll in Medicare Part B
The Centers for Medicare & Medicaid Services manages Medicare and there are certain rules about if and when you are required to file for Medicare Parts A and B. For more information about filing for Medicare:

Once you have Medicare Parts A and B, verify that your record in the Defense Enrollment Eligibility Reporting System (DEERS) has been updated to reflect that. The Centers for Medicare & Medicaid Services automatically sends Medicare updates to DEERS, but you should verify that the information has been received (see “Stay Eligible for TRICARE: Keep DEERS Up to Date”).

It’s important to remember that if you have Medicare Part A, you also must have Medicare Part B in order to remain eligible for TRICARE.

The exceptions to this rule are when:

See Medicare providers 
When using TFL, there will be a slight change in your benefits and how you get care. You must see Medicare providers in order for Medicare and TRICARE to pay for services that are covered by both programs. In most cases, TRICARE-authorized providers are Medicare providers as well. There’s a good chance that the providers you saw using TRICARE Standard are Medicare providers. You can ask your provider or check with Humana Military.

When you receive care that is covered by both Medicare and TRICARE, your provider will file the claim with Medicare; Medicare will pay its portion and then forward the claim to TRICARE, which, in turn, will pay its portion.

Visit www.tricare4u.com and learn more about TFL
Wisconsin Physicians Service (WPS) administers TFL. Visit their Web site to get more information about the program. Register and you can view the status of claims, update other health insurance information and verify your TRICARE eligibility information through DEERS.

You can also find out more about WPS’s new explanation of benefit (EOB) processes. WPS now sends one monthly consolidated EOB which lists all claims activity, rather than one EOB per claim. Also, you can choose to receive your EOBs electronically in place of hard copy EOBs.

Medicare Part B Surcharge
Medicare charges a 10% surcharge for every year you delay the purchase of Medicare Part B from the time you were first eligible to do so. And although in certain cases TRICARE does not require you to purchase Medicare Part B, you may still incur the Medicare surcharge if you do not purchase Part B when you first become eligible to do so.

If you have an active duty sponsor, you will not be subject to the Medicare Part B surcharge as long as you enroll in Part B while your sponsor is on active duty or within the first eight months of your sponsor’s retirement. Note: To avoid a break in your TRICARE coverage, you should enroll in Medicare Part B before your sponsor retires.

If you do not have an active duty sponsor and are enrolled in the USFHP or TRS, you are not protected from the Medicare Part B surcharge should you decide to participate in standard Medicare at a later date. Therefore, to avoid the surcharge, you should purchase Part B when you are first eligible to do so, even though TRICARE may not require it.

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