Q. I have received disability retirement from the military since age 31. I have been using Tricare Prime, but recently received notification in the mail that I am now under Medicare. I opted only for Part A inpatient insurance and rejected Part B outpatient insurance, because I figured I already had Prime. Now I'm told I am no longer eligible for Tricare Prime if I am eligible for Medicare. So now I have to pay for Medicare Part B and also Tricare for Life? I'm confused about this. ... I really wanted to keep Prime because it was simple and affordable.
A. Unfortunately, you are no longer eligible for Tricare Prime, precisely because you are eligible for Medicare.
For most beneficiaries, this transition normally happens at age 65, but it happens sooner for individuals like yourself who become eligible for Medicare earlier than age 65 due to disability. You now must use Tricare for Life, under which Medicare acts as first payer and Tricare Standard acts as a backup second payer. And enrollment in Part B and payment of the Part B premium ($104.90 a month for most individuals) is a requirement in order for you to use the Tricare portion of your Tricare for Life benefit.
Under TFL, the Medicare Part B premium will be your only recurring cost; no premiums are required to use Tricare Standard. The combination of Medicare and Tricare Standard should cover 100 percent of your costs on the vast majority of your health care claims.
You must enroll in Part B in order to take full advantage of your Tricare for Life coverage. You need to contact your local Social Security office and ask for guidance on enrolling in Part B. Once you have that squared away, contact the Defense Enrollment Eligibility Reporting System to make sure your current status as a TFL beneficiary is reflected in the DEERS database. You can engage that agency by visiting the ID Card/DEERS office on any military installation or by calling the main DEERS support office at 800-538-9552.
Q. My separation date is approaching, and I recently found out that I'm pregnant. Will I still be covered by Tricare until after the pregnancy?
A. Unless the circumstances of your separation qualify you for extended health care coverage under the military's Transition Assistance Management Program, military health care benefits for both you and your baby will end as of your separation date.
Post-separation TAMP eligibility is determined by the individual services and the Defense Enrollment Eligibility Reporting System under very specific circumstances and scenarios.
To determine whether you qualify, visit www.tricare.mil/tamp. You may also call the main DEERS support office in California for more information.
Email tricarehelp@militarytimes.com. Include the word "Tricare" in the subject line.
