How does Tricare and VA work with Medicare?
Service members who leave active duty may qualify for health care coverage through either the Department of Veterans Affairs (VA) or TRICARE, depending on how they separated from the military.
But what happens to your VA or TRICARE benefits when you turn 65, which is the age most people become eligible for Medicare? Do veterans and military retirees have to take Medicare Part A and Medicare Part B, or do the VA and TRICARE provide enough coverage?
It’s all about what works for you. Medicare can add another layer of coverage, protection, cost savings, and convenience if you already have VA benefits or TRICARE. Here’s how.
VA benefits and Medicare enrollment
You can be enrolled in benefits through Veterans Affairs (VA) and Medicare at the same time. Having both gives you more options for care, as well as the flexibility and freedom to choose providers within the VA or with a non-VA provider in your Medicare network. Plus, Medicare Advantage plans can come with extra benefits that most veterans don’t receive through the VA, such as dental, vision, gym memberships, over-the-counter allowances and transportation benefits.
How Medicare and VA benefits work together
Although you can have benefits through Veterans Affairs (VA) and Medicare, you’ll need to choose which benefits you want to use when receiving care:
- To use your VA benefits, you must visit a VA doctor or VA medical facility. The VA may also cover care at a non-VA facility if it’s preauthorized.
- To use your Medicare benefits, you must receive care at a Medicare-authorized facility. In some cases, Medicare may also be able to pay for services the VA has not authorized.
What Medicare does and doesn’t cover will depend on your plan, where you’re receiving care, and which benefits you plan to use — if you can use both.
TRICARE and Medicare enrollment
As a veteran, your coverage under TRICARE ends once you become eligible for Medicare. That means you’ll need to enroll in Medicare Parts A and B during your Initial Enrollment Period to avoid any lapse in TRICARE coverage. When you enroll in Medicare Parts A and B, TRICARE will automatically switch to TRICARE For Life (TFL). TFL acts as supplemental coverage for your Medicare plan. That means Medicare is your primary payer, while TFL reduces or eliminates out-of-pocket costs for deductibles, coinsurance, and copayments.
How Medicare and TRICARE work together
When you have Medicare and TRICARE For Life, you can visit any authorized provider. Here’s how the two work together to pay your health care costs:
- The provider will file the claim(s) with Medicare.
- Medicare will then pay the portion it’s responsible for and send the claim to the TRICARE For Life.
TRICARE For Life will pay its portion directly to the provider for the services TRICARE covers.
There are so many factors to consider when choosing the Medicare coverage that is right for you, and it can be an overwhelming process. We would love for you to schedule a free consultation to go over your unique needs. We want to empower you to choose the coverage that is the best for you.
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