TRICARE For Life (TFL) offers Medicare-wraparound coverage to TRICARE beneficiaries regardless of age, provided they are entitled to Medicare Part A and also have Medicare Part B coverage.* Under the TFL program, your provider will file the claims with Medicare. Medicare will pay its portion and automatically forward the claim electronically to TRICARE for processing.
Here are some features of TFL:
- Must have Medicare Part B coverage*
- May receive care from any Medicare provider
- Claims processed as follows:
- For services covered by both Medicare and TRICARE, Medicare pays first and TRICARE pays second. You pay nothing out of pocket.
- For services covered by TRICARE, but not by Medicare, TRICARE will pay its portion and you are responsible for applicable TRICARE deductibles and cost-shares.
- For services covered by Medicare, but not by TRICARE, Medicare will pay its portion and you are responsible for applicable Medicare deductibles and cost-shares.
- For services not covered by Medicare or TRICARE, you are responsible for the entire bill.
- For all Medicare-eligible ADFMs, claims for inpatient services will be processed as described above. For outpatient services, if an ADFM is not enrolled in Medicare Part B, TRICARE will pay its portion and you are responsible for any applicable TRICARE deductibles and cost-shares (like any ADFM not entitled to Medicare).
TFL is administered by Wisconsin Physicians Service (WPS). If you are eligible for TFL, visit the TRICARE4U Web site or contact WPS at 1-866-773-0404. Additional steps may be required to coordinate benefits if you have other health insurance in addition to TRICARE and Medicare.
*With the exception of ADFMs and USFHP enrollees, all beneficiaries entitled to Medicare Part A must have Medicare Part B coverage to maintain their TRICARE eligibility.
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