Some people have multiple types of health insurance, so it is important to know that Medicare coverage works differently with other kinds of insurance. This article reviews how Medicare works with two kinds of military benefits—TRICARE and Veterans Affairs benefits.
First, let’s start with TRICARE.
TRICARE is a health insurance program provided by the federal government to active duty and retired military personnel and their family members. There are many different TRICARE programs.
TRICARE for Life is a program for Medicare-eligible military retirees and their dependents. It is often shortened to TFL. If you have TFL, you are required to take Medicare if eligible for it. TFL acts as a supplement to Medicare, meaning that Medicare is your primary insurance and TFL usually pays the remaining costs. TFL also offers a pharmacy program that provides creditable drug coverage. This means you may choose to delay Medicare Part D enrollment without penalty and continue using TFL’s pharmacy program.
If you are an active-duty service member or active-duty family member, you may be enrolled in a different TRICARE insurance program. You can typically delay Part B enrollment if you are an active-duty member or family member and enroll in Medicare using the Part B Special Enrollment Period when you are no longer active duty. If you choose to enroll in both, TRICARE is your primary insurance and Medicare pays secondary.
You can visit the TRICARE website at www.tricare.mil to learn more about your TRICARE coverage.
Next, we’ll look at Veterans Affairs benefits.
Veterans Affairs benefits, also called VA benefits, are administered by the federal government for veterans. You can have both Medicare and VA benefits, but the two do not work together. Your VA coverage generally only works in VA facilities, and Medicare does not work in VA facilities. This means that if you choose not to enroll in Medicare and to keep only your VA coverage, you will not have health insurance for facilities outside the VA system.
Enrolling in Medicare gives you more flexibility in what doctors and facilities you go to, while also having VA benefits to cover things not covered by Medicare, such as hearing aids and dental care. Some people choose to enroll in Medicare Part A because it’s often premium-free, but they turn down Part B because of the monthly premiums. In this scenario, though, you would not be eligible for the Part B Special Enrollment Period and would likely face premium penalties if you decide to enroll in Part B in the future.
Do note that people with limited income and assets may qualify for cost assistance programs that would cover the cost of the Part B premium. You can contact your State Health Insurance Assistance Program (SHIP) to learn if you’re eligible for assistance with your Medicare premiums. Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.
VA drug coverage is creditable, meaning you can delay Part D enrollment without penalty. Typically, VA drug coverage has no premiums and limited copayments for prescriptions, but you must use VA pharmacies and facilities.
You can call 800-827-1000 or visit www.benefits.va.gov to learn more about your VA benefits.
Finally, it’s helpful to know how to avoid problems with your coordination of benefits.
If you have more than one type of insurance, you should inform your healthcare provider. Bring your different health insurance cards to your medical appointments and show them at the front desk. It is helpful to let them know which insurance is primary and which is secondary to avoid any billing problems. If your secondary insurance is billed first, for example, you may experience coverage denials or other difficulties accessing services because your secondary insurance will not pay until the primary insurance does. (See this Medicare Coordination of Benefits publication for more details.)
Still have questions?
Your SHIP is here for you! You can contact your SHIP for any other Medicare-related questions or concerns you have. SHIP counselors are government funded to provide trusted, unbiased Medicare counseling at no cost to you. (Depending on your state, your SHIP may go by another name.) Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.
Explore more blogs: