Medicare and Military: Navigating Your Healthcare Options

When it comes to healthcare, both veterans and active-duty military members have a lot to consider. If you've served in the military, you might be familiar with the TRICARE system. But what happens when you become eligible for Medicare? Here's a breakdown of how Medicare interacts with military benefits.

TRICARE and Medicare: The Basics

TRICARE is a health care program for active-duty and retired uniformed services members and their families. As you approach age 65, though, Medicare becomes a factor.

• TRICARE For Life (TFL): For those who are eligible for both Medicare and TRICARE, TFL acts as a secondary payer to Medicare. This means that after Medicare pays its portion of the healthcare expenses, TFL will usually pay the remaining out-of-pocket costs.

How to Coordinate Benefits

1. Enrollment in Medicare Part B: To maintain TRICARE benefits once you're eligible for Medicare, you must enroll in Medicare Part B. If you don’t, you can lose your TRICARE benefits.
2. Medicare as the Primary Payer: For most services, Medicare will pay first (primary payer), and TFL will pay second. There are exceptions, like if you receive care at a military hospital or any other federal provider.
3. Pharmacy Benefits: While Medicare offers prescription drug plans via Part D, TFL provides its pharmacy benefit, which often proves sufficient for many beneficiaries.

Considerations for Active Duty Military Members

• Delaying Part B: If you're on active duty or have a spouse on active duty, you can delay Part B enrollment without facing a late penalty. This allows you to rely on TRICARE without the added expense of Part B premiums. Once the active-duty service ends, you have a special enrollment period to sign up for Part B.

Veterans Affairs (VA) Benefits and Medicare

Some military retirees might receive benefits from the VA. It’s possible to have both VA benefits and Medicare.

• Using Both Systems: VA benefits and Medicare do not coordinate benefits. If you go to a non-VA hospital or doctor, Medicare will cover its portion, but the VA typically won't contribute. Conversely, if you receive care at a VA facility, VA benefits will apply, and Medicare will not.
• Advantage of Dual Enrollment: Having both can offer flexibility in choosing providers and ensuring coverage regardless of where you receive care.

In Conclusion

Navigating the landscape of Medicare and military benefits can be challenging. It's essential to be proactive, understand how the systems work together, and make informed decisions that optimize your health coverage. Whether you're a veteran, an active-duty service member approaching retirement, or a military family member, understanding the interplay between Medicare and military benefits is crucial for your healthcare journey.