Tricare Help: Wartime service no guarantee of Tricare for Life - Getting out, military health issues - Navy Times

Tricare Help: Wartime service no guarantee of Tricare for Life

Answering your questions on Tricare.

Q. I have had a job with good health insurance for almost 30 years. I’ll lose my employer’s insurance if I retire next year at age 65. How do I enroll in Tricare for Life based on my wartime military service? I served in Vietnam, but have never used Tricare.

Tricare for Life consists of full coverage by Medicare, Part A and Part B, plus full coverage by Tricare Standard. A retiree must be eligible for Medicare and for Tricare, and be enrolled in Medicare, Part A and Part B, to be eligible for Tricare for Life.

Tricare eligibility is established by federal law for certain categories of people. Not all who served in the military, even in wartime, are eligible.

For those who have left service, the basic eligibility criteria for Tricare is to have earned military retirement benefits by serving at least 20 years in uniform or by being medically retired for disability. The wording of your letter makes me suspect neither is the case for you.

You should call the Defense Enrollment Eligibility Reporting System support office, tollfree, at 800-538-9552, to find out whether you are eligible for Tricare.

Social Security wants a person to apply for Medicare at least 90 days before the effective date of his Medicare coverage. That’s usually on the first day of the month when he will be 65 years old, or the first day of the previous month if he was born on the first of the month.

You’ll need to do that regardless of whether you’re eligible for Tricare.

Q. I’ll get Medicare in January. I know I must enroll in Part A and Part B, but does Tricare require me to enroll in Medicare’s pharmacy plan, Part D?

No. The Pentagon’s Office of Health Affairs is on record as stating that the only Tricare beneficiaries who might benefit from enrollment in Medicare Part D are those whose incomes are so low that they qualify for financial aid to pay their Medicare Part B premiums. OHA does not recommend Medicare Part D for most Tricare beneficiaries.

Some Medicare Advantage plans require enrolling in Part D. Tricare is not involved in those requirements. Medicare Part D, however, will be seen as “other health insurance,” and will prevent your using the Tricare Mail Order Pharmacy Plan. You will have to use your Part D plan first, before you can use your Tricare Pharmacy Plan, even for local drug purchases.

If you’re enrolled in Part D, you may file Tricare claims for the costs of drugs that exceed Tricare’s cost shares for those drugs. But you must first buy the drugs through your Part D plan.

All Tricare beneficiaries are automatically covered for the free Tricare Pharmacy Program. The coverage, not the drugs, is free.

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Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In e-mail, include the word “Tricare” in the subject line and do not attach files. Get Tricare advice anytime on our blog.