Whether active duty, retired military or veteran, there are important points of intersection and interaction between Medicare and military health coverages
Jun 7, 2016 @ 11:27 am
By Katy Votava for Investment News
Whether active duty, retired military or veteran, there are important points of intersection and interaction between Medicare and military health coverages. Those points fall into three categories related to: active duty military; TRICARE for Life for retired military and their spouses; and veteran’s health benefits for all those who have served.
While on active duty, most service personnel are covered by a variety of military health care options. As is the case in the civilian world, if a service person becomes Medicare eligible, they need to consider their Medicare options particularly as they relate to Medicare Part B. Military health coverage entitles the service person to delay Medicare Part B enrollment until a future date. They will be eligible for a Special Enrollment Period (SEP) to enroll in Medicare Part B without penalty when they leave active duty medical coverage.
However, if your client is Medicare eligible and an active-duty service member or spouse of an active-duty service member:
• Before the active-duty health plan ends, they must enroll in Parts A and B to avoid a lack of coverage.
• They can get Part B during a Special Enrollment Period if they are Medicare eligible because they 65 or older, or are disabled.
Retired military who are under 65 years of age, and their families, are eligible for TRICARE health coverage. When a military retiree or spouse reaches 65, they are eligible for Medicare and TRICARE for Life medical coverage. TRICARE for Life is specifically for Medicare eligible military retirees.
Medicare pays first for Medicare-covered services. TRICARE for Life will pay the Medicare deductible and coinsurance amounts and any service TRICARE for Life covers that Medicare doesn’t cover. The beneficiary pays the costs of services that neither Medicare nor TRICARE for Life cover.
TRICARE for Life beneficiaries must enroll in Medicare Parts A and B. They do not need to enroll Medicare Part D because TRICARE for Life provides Medicare Part D creditable coverage. If they do join a Medicare Part D plan, that plan pays first, and TRICARE for Life pays second. Given that TRICARE for Life functions as a Medicare supplement, a Medigap plan or Medicare Advantage is not needed. That said, a person can opt into a Medicare Advantage plan and TRICARE for Life will coordinate benefits with that plan.
In my experience, people seldom benefit from joining either a Medicare Advantage plan or Medicare Part D plan in addition to TRICARE for Life. An added bonus of TRICARE for Life is that it includes coverage of international health care services.
Veteran’s Administration (VA) health coverage is for veterans and those who served in the U.S. military. These benefits are available to most veterans whether retired military or not. Current and former members of the Reserves or National Guard who were called to active duty by a federal order and completed the full period for which they were called may be eligible for VA health benefits as well.
The VA provides a wide range of health benefits based on a hierarchy of enrollment criteria. Veterans who meet certain criteria may receive a major portion of their health services through the VA. If that person needs care outside of the VA system they will need to pay for that themselves or have other coverage. A Medicare Advantage with a Part D plan can serve as a back-up coverage in these circumstances.
VA Prescription drug coverage can pay for a major portion of a person’s prescriptions at a relatively low cost. This is a valuable benefit that is available to most Medicare eligible veterans. It is worth taking a look at because the cost savings to your client can be significant. Given that the VA does not cover all medications I recommend that the person join a Medicare drug plan as a backup. They cannot use both types of coverage for the same prescription at the same time.
WHERE TO FIND HELP
If your client is:
• A veteran or has served in the U.S. military can contact Department of Veterans Affairs to get answers to their questions about VA benefits:
— Call 1-800-827-1000, TTY 1-800-829-4833, or visit VA.gov
• Retired military under 65 years and not eligible for Medicare can get in touch with TRICARE to determine which regional office covers them and find associated contact information.
• Medicare-eligible retired military who are either under or over 65 and can contact TRICARE for Life:
— Call 866-773-0404, or visit Tricare.mil.
Optimizing Medicare and military health benefits in retirement will save your clients significant money in year over year out-of-pocket expenses. That guidance can also help them increase their access to needed health services. The ultimate impact is that your clients’ retirement nest egg goes further and allows them the retirement flexibility that you helped them plan for. It may even help them improve their health. That’s a win win