Making the Most of Your Military TRICARE Insurance and VA Benefits

Being a veteran or a retired military personnel comes with the perk of eligibility for some unique benefits, through existing VA coverage or TRICARE insurance. We deeply appreciate the sacrifices made by our military persons, given their unshakeable willingness to serve our country. As such, we’ve put together this comprehensive guide tailored specifically for those of you who hold these insurance benefits, and are eligible for Medicare.

Navigating VA Benefits with Medicare

When you reach the age of 65, it’s important to understand how your VA benefits and Medicare interact. The VA and Medicare systems are completely separate and do not bill each other. If you have comprehensive VA coverage, including prescriptions, you have the option to enroll in Medicare Part A only and bypass Medicare Part B, which comes with a premium. This decision allows you to make the most of your VA coverage while still accessing important Medicare benefits.

The 2023 premium for Part B is at $164.90, significant enough for some individuals to opt out. However, it’s crucial to consider the associated trade-offs.

Not enrolling in Medicare at 65, when first eligible, has significant implications. During your “initial enrollment period”, which spans seven months surrounding your 65th birthday, you have the opportunity to enroll in Medicare Part B. However, if you miss this window, you can only enroll during the “general enrollment period” from January to March each year. Additionally, for every 12 months you go without enrolling after becoming eligible, you will incur a 10% penalty on your Part B premium. It is crucial to carefully consider your options and the potential constraints and penalties in these circumstances.

VA health coverage does not qualify as creditable coverage under Original Medicare. This means that if you fail to enroll in Medicare at the age of 65 and do not have another form of creditable coverage, you may face lifelong penalties.

However, Drug coverage provided through the VA is considered creditable coverage, so an additional Part D plan is not necessary.

Making the Most of Your TRICARE For Life with Medicare

As you transition to TRICARE For Life, a different set of rules come into play. When you near the age of 65, TRICARE shifts from being your primary insurance to working alongside Medicare. This means that enrolling in both Medicare Part A and Part B becomes mandatory. It’s important to note that it is ideal to enroll in Medicare three months before your 65th birthday month to ensure seamless coverage.

Once you enroll in both Medicare Part A and Part B, TRICARE becomes TRICARE For Life and takes on the role of the secondary payer for your medical bills. This means that you will typically not have to pay out of pocket for your medical expenses. And the best part is that TRICARE provides comprehensive prescription drug coverage independent of Medicare Part D, ensuring that your medication needs are well taken care of.

Medicare Advantage Plans: Exclusive Benefits for Veterans, Eligible Family Members, & FEHB Recipients

For veterans or those on TRICARE for Life, you might want to consider the unique coverage options available to you through Medicare Advantage plans. This approach is perfect for individuals seeking coverage that extends beyond VA or TRICARE For Life. It’s important to keep in mind that this option is exclusively available to those who have retired from the military or federal government and are benefiting from FEHB coverage.

A Medicare Advantage plan opens up the opportunity to access healthcare from civilian doctors and hospitals, providing an alternative to the VA system. The perks of enrolling in a Medicare Advantage plan extend beyond just medical coverage. You can enjoy significantly low or even zero copays, along with additional benefits like dental care, eyewear, hearing aids, and gym memberships. These benefits are available to both VA beneficiaries and those enrolled in TRICARE For Life. However, it’s important to note that these two groups utilize the Medicare Advantage Plan in slightly different ways.

If you have VA benefits and are enrolled in an MA-only plan without embedded drug coverage, it’s important to keep in mind that while your options expand with access to civilian health providers, you will be responsible for some reasonable copays. However, there is a silver lining. You will receive a credit towards your Part B premium, effectively reducing the amount you have to pay. In addition, you’ll also enjoy a range of extra perks as mentioned earlier. With TRICARE, you’re not responsible for co-pays as the provider bills the Medicare Advantage company first then sends the balance to TRICARE – assuring a near zero out-of-pocket cost.

Conclusion

Understanding and navigating insurance and benefits can be complex, but by gaining clarity on your options and potential outcomes, you can confidently make decisions that prioritize your best interests. It’s important to remember that these exclusive options are specifically designed for our esteemed military retirees and veterans as a heartfelt token of gratitude for your dedicated service to our nation.