Military
lthough many of my readers here at PhilFAQS are not US military and former US military, a sizeable percentage are, including your faithful scribe. From time to time I see news that are pretty important to us retired military folks but likely not of much interest to other readers … so I decided to start this page to provide one location to keep all the military “tidbits” for easy access.
By the way, an even tinier segment of the readership here is former military from other than the US … my most hearty welcome and if you have particular information to share with your countrymen … or have particular question you’d like answered, feel free to give me a shout on the contact page.
One thing that every military/former military person needs is the ’straight skinny’ on benefits and programs that affect him or her. This is often one of the hardest things to find. ’Guardhouse lawyers’ and self-styled experts who know ‘everything’ abound. To give yourself an even chance and level the playing field, you might want to give these guys a try. They publish, for free, some comprehensive Military Handbooks that will help you navigate yourself to a successful career and retirement. Recommended.
TRICARE for Life: Top 10 “Need-to-Knows”
If you’re nearing retirement, transitioning health care coverage shouldn’t be a hassle. As you’re preparing to switch to TRICARE for Life (TFL), the following facts and tips will help you make a seamless transition to TRICARE for Life (TFL) coverage.
Enroll in Medicare Part B when first eligible.
TFL enrollment hinges on enrollment in Medicare Part B. You must remain enrolled in Medicare Part B (medical care) in order to maintain TRICARE eligibility.
Keep DEERS up to date.
Although Medicare provides data to DEERS, you must maintain your TRICARE eligibility by keeping DEERS up to date any time there is a life changing event, like becoming eligible for Medicare. Contact DEERS online at www.dmdc.osd.mil/rsl or call toll-free 1-800-538-9552.
Enrollment in TFL is seamless.
If you are receiving Social Security benefits, you will transition smoothly to TFL upon your 65th birthday; if you are not receiving Social Security benefits at the time of your 65th birthday, you will need to visit the nearest Social Security office and enroll in Medicare.
Medicare authorized providers are also TRICARE authorized.
You can visit any Medicare provider for care since all Medicare providers are also TRICARE authorized. Simply show your Medicare card and Uniformed Services ID card at your appointment.
Claims are paid automatically between Medicare and TFL.
As a TFL beneficiary, you will not need to submit a paper claim when you have a doctor’s visit (in most cases). The provider will submit the claim to Medicare. Medicare will then submit the claim to TRICARE once the Medicare portion is paid.
TFL is considered a second payer to Medicare.
For services covered by Medicare and TRICARE, Medicare will pay its portion of the claim and TRICARE will pay the remainder. For services that are covered by Medicare and not by TRICARE (such as chiropractic care) TRICARE will not make a payment and the beneficiary will be responsible.
Services covered by TRICARE but not Medicare (such as overseas claims) may be billed directly to Wisconsin Physicians Services (WPS) and TRICARE will pay as primary insurer. You will be responsible for any cost shares. Payments for services that are not covered by either program remain your sole responsibility.
Other health insurance (OHI) coordinates differently with TFL and Medicare.
TFL beneficiaries who have OHI need to submit their Medicare Summary Notice with a paper claim and OHI explanation of benefits (EOB) to Wisconsin Physician Services. The paper claims may be sent to:
Wisconsin Physician Services
TRICARE for Life
P.O. Box 7890
Madison, WI 53707-7890
Enrollment in Medicare Part D is not necessary.
The TRICARE pharmacy benefit is considered creditable coverage and pays equally to Medicare.
TFL beneficiaries may continue to use any of the TRICARE pharmacy programs.
You may fill prescriptions at any military treatment facility pharmacy, through the
TRICARE Mail Order Pharmacy or through any TRICARE network or non-network pharmacy.
TRICARE coverage continues for eligible family members after the death of a sponsor.
Surviving spouses remain eligible for TRICARE unless they remarry. If they remarry, they lose TRICARE eligibility and cannot regain eligibility later, even in cases of divorce or death of the new spouse. Unmarried surviving children remain eligible for TRICARE until their 21st birthday (or 23rd birthday if enrolled in college full time and if at the time of the sponsor’s death, the sponsor provided more than 50 percent of the child’s financial support.) For more information on TRICARE for Life, please visit www.tricare4u.com or call Wisconsin Physicians Services toll-free at 1-866-773-0404.
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