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Questions About Medicare + Tricare?

I hope all is well in your world and you are staying safe and sane in these crazy times.

I wanted to touch on Tricare and Medicare and how it works. We in the office speak to people that are on Tricare and have questions about how it will work when they go on Medicare. I have included the pamphlet from Tricare explaining the way it works. It is highly informative.

Here are some highlights:

  • To have Tricare for Life, you must have premium-free Part A and enrolled in Part B from Medicare. In most circumstances, Medicare will be the primary and Tricare will act as the secondary or supplemental policy.

  • If you are getting a procedure done and it is both Medicare and Tricare approved, then Medicare will be the primary and Tricare will be secondary, and you will owe nothing.

  • If it is not Medicare-approved but Tricare does cover it then you will be responsible for Tricare’s deductible and cost-share.

  • If it is Medicare-approved and not Tricare approved, then you are subject to Medicare’s deductible and cost-share.

  • If neither Medicare nor Tricare cover the procedure you are responsible for the whole cost yourself.

  • If you are currently covered by an employer policy and go on to Medicare, it may be in your best interest to delay enrolling in Part B, as this will save you the Part B premium. If you go this route you will not be eligible for Tricare for Life, as you must have both Part A and Part B to receive Tricare for Life. This will not stop you from getting Tricare for life when you retire from your job and lose Employer-based coverage, it would just delay enrollment.

  • If you opt to enroll in Part A and Part B when first eligible and are covered by an employer policy, in most circumstances, the employer coverage is primary, Medicare is secondary, and Tricare will be the last.

In most cases, I would recommend delaying Part B enrollment until you retire. Three months before retirement you enroll in Part B, during the Special Enrollment Period, which triggers the retirement, and then get with Tricare to enroll in Tricare for Life at that time. I have included a link for those forms as well. This is a brief breakdown of Tricare and how it works. Please look over the information and let me know if you have any questions.

As always, do something nice for someone just because.

Part B enrollment form link:

(takes you to the direct CMS.Gov form)

All the Best,

Randall J. Lawson

Owner/Medicare Specialist

The HgO Group

803-851.0219 office

(888) 449-4863 toll free

National Producer Number #9276045

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