10 October 2016
Category Medicare

What about Medicare Advantage for People on Tricare?

We often get questions from retired military personnel as to whether they can have Tricare and Medicare Advantage coordinate together.  The answer is yes – the TFL handbook makes it clear that TFL will pay after any other insurance, including Medicare Advantage.

However, it is rare that someone would want to do this because on Medicare Advantage plans, you are responsible for copays outlined in the Summary of Benefits at the time of service. It is possible that by filing claims forms after your MAPD first pays, that you might be able to get TFL to reimburse for these copay expenses. However, you could avoid that scenario entirely if you just remained in Original Medicare A & B and let that coverage coordinate with your TFL.

Over the years, we’ve had some beneficiaries express interest in certain Medicare Advantage plans that offer “extra” benefits such as coverage for dental, hearing and vision or free gym memberships provided by some plans. Since Original Medicare does not provide benefits for this, these individuals have wanted to enroll in Medicare Advantage to get these benefits. It is your right to do so if you wish. Just be aware then that once enrolled, you cannot dis-enroll from a Medicare Advantage plan in most cases until the Annual Election Period in the fall.

Also, the Part D medication benefits within a Medicare Advantage Prescription Drug Plan can affect their ability to access their drug benefits under TFL. For this reason, considering a Medicare Advantage-only plan (no Part D included) might be a better route to go.

We encourage all beneficiaries to carefully review their TRICARE Handbook before making enrollments into Medicare Advantage or Part D coverage. If you feel unsure, contact an agent for help or call TRICARE directly for assistance.

Leave a Reply

Your email address will not be published. Required fields are marked *