As a military veteran, this month’s topic resonates with me. Medicare can work with military-related healthcare, whether you are a military veteran or a military retiree. As a reminder, Original Medicare (available to the majority of eligible Alaskans) consists of Part A (hospitalization insurance) and/or Part B (medical service providers insurance). Part D is Medicare’s prescription drug plan benefit offered through third-party insurers who are approved both by Medicare and the State of Alaska.
Medicare and Veterans Affairs benefits
If you are a military veteran, you may choose to receive health care benefits from the Dept. of Veterans Affairs (VA). You can have both Medicare and VA benefits, but the two are not fully interchangeable. You usually only get VA benefits at VA facilities, and Medicare does not work in VA facilities. The VA does cover some services that Medicare may not, such as hearing aids and dental care; eligibility for specific services may relate to a service-connected disability and income.
However, if the VA is your only coverage, you will not have insurance for care outside the VA system. Because of that, some people also enroll in Medicare, so they have more choices for doctors and facilities. Your VA benefits include prescription drug coverage, and you can choose to not to sign up for Medicare’s Part D prescription drug coverage. However, if you want to use pharmacies outside of the VA network, then you will need a Part D plan to provide that coverage. If you choose to sign up for Part D later, you will not have to pay a penalty for signing up late, since VA pharmacy coverage is creditable as a Part D plan.
Medicare and TriCare benefits
As part of the military health system, TriCare is health insurance coverage for military retirees (and eligible dependents), reservists who elect coverage (and eligible dependents), and eligible dependents of service members still on active duty. There are different TriCare programs, based in part on the enrollment and premium levels; this article will focus on TriCare for Life, which is for Medicare eligible enrollees, which for most is when you turn age 65.
For military retirees and eligible dependents, upon age 65, the Dept. of Defense requires enrollment into Medicare Part B in order to retain TriCare benefits; previous TriCare coverage (such as TriCare Prime or TriCare Select) then becomes TriCare for Life coverage.
TriCare for Life insurance is secondary coverage to Medicare. When you receive care at a Medicare-certified facility, Medicare will pay the majority of the claim, with TriCare for Life usually covering the remaining amount. TriCare for Life also includes creditable prescription drug coverage, meeting or exceeding the requirements of a comparable Part D plan.
TriCare for Life is similar to Medicare Supplement Insurance (or Medigap) coverage plans, but with the addition of prescription drug coverage. Beneficiaries seek out care through Medicare’s available provider network with TriCare for Life seamlessly acting as secondary insurance coverage.
While Original Medicare is for medical services within the United States of America, TriCare for Life can offer healthcare coverage for those who are residing or traveling outside of the United States. In such cases, TriCare for Life becomes primary coverage with an annual deductible and cost-sharing for services received.
Contact us
For any Medicare-related questions, please feel free to contact the State of Alaska Medicare Information Office at (800) 478-6065 or (907) 269-3680. Our office is also known as the State Health Insurance Assistance Program (SHIP), the Senior Medicare Patrol (SMP), and the Medicare Improvements for Patients and Providers (MIPPA) program.
If you are part of an agency or organization that assists seniors with medical resources, consider networking with the Medicare Information Office. Call us to inquire about our new Ambassador program.
Sean McPhilamy is a volunteer and Certified Medicare Counselor at the Alaska Medicare Information Office.
