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Tricare Help: Part B enrollment required for over-65 crowd

Jul. 17, 2014 - 12:56PM   |  

Q. I am retired from the Air National Guard, enrolled in Medicare Parts A and B and using Tricare for Life. My wife will soon turn 65. She has a health plan provided by her employer and intends to keep working for a while longer. She just received a letter from Tricare about enrolling in Part B. If she chooses to wait until she retires to enroll in Part B, will she be penalized by Tricare? I faced the same situation when I turned 65 — I was told I would incur Tricare penalties if I did not sign up for Part B. The information from Tricare is contradictory and confusing on this subject.

A. It’s not accurate to say that Tricare “penalizes” people who don’t sign up for Medicare Part B at age 65. Rather, Medicare-eligible people over 65 who choose not to sign up for Part B simply cannot use their Tricare benefits until they do. Part B enrollment and payment of the monthly Part B premiums are bedrock requirements of Tricare eligibility for over-65 beneficiaries.

Generally, Medicare does charge a monetary penalty to people who turn 65 and don’t sign up for Part B when they first become eligible, but then decide to enroll later. This “late enrollment penalty” is equal to 10 percent of the Part B premium for each year that a beneficiary was eligible to sign up but for whatever reason chose not to.

However, there is one big exception to the above, and it directly affects people like your wife who choose to continue employment past age 65: As long as such individuals have continued access to employer-provided health insurance, they may delay Part B enrollment for as long as they continue working without having to worry about the late enrollment penalty. (They must enroll in Part B within eight months of the end of work or the end of the employer coverage, whichever comes first, to avoid a break in coverage.)

But again, those beneficiaries cannot use Tricare until such time as they enroll in Medicare Part B.

Q. I recently divorced. My ex-husband joined the military in 1988, we married in 1991, and he retired from service in 2008. Am I correct in thinking that I fall under the “20/20/15” rule for post-divorce Tricare coverage?

A. That’s correct. Your ex-husband served in uniform for at least 20 years, your marriage lasted at least 20 years, but his service and your marriage overlapped by only 17 years. So you fall under the 20/20/15 rule that grants former spouses one year of extended Tricare coverage.

You don’t say how long ago you divorced, but if you haven’t already set yourself up with Tricare, you need to do so quickly — in these scenarios, that one-year clock begins ticking on the day the divorce is finalized.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In email, include the word “Tricare” in the subject line and do not attach files. Get Tricare advice any time at www.militarytimes.com/tricarehelp.

Answers by RallyPoint

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