What About Medicare Advantage for People on Tricare for Life (TFL)?

Many Medicare recipients with Tricare for Life express interest in Medicare Advantage (MA) plans. That’s because Original Medicare doesn’t include “added” benefits like coverage for chiropractic, dental, hearing, vision, and fitness. Since Original Medicare does not provide these benefits, Medicare Advantage plans are a way for people with Tricare for Life to get some added benefits at little cost.

As an example, some Tricare for Life recipients enroll in Medicare Advantage so they can get the SilverSneakers benefit. And since TFL already includes drug coverage, enrollees often choose to join an MA-only plan (without drug coverage). Many MA and MA-only plans have low monthly premiums.

Enrollees must remember though when they enroll in a Medicare Advantage plan, the MA plan is now primary. However, Tricare for Life is unique in that it may pick up the copays on the Medicare Advantage plan, leaving members with little out-of-pocket.

Since enrollment in a Medicare Advantage plan or standalone Prescription drug plan may affect a person’s TFL benefits, we strongly encourage individuals to:

1. Review their TRICARE for Life Handbook carefully, and
2. Contact their TFL administrator and discuss enrolling in a Medicare Advantage plan with or without prescription drug coverage, or a standalone Prescription Drug plan before completing an enrollment.

Here’s some TFL information you may find helpful:

• Website: www.Tricare4U.com
• Phone: 1-866-773-0404 (TTY: 711)
• TFL is TRICARE’s Medicare-wraparound coverage available worldwide to TRICARE-eligible individuals who are entitled to Medicare.
• Members must be enrolled in Original Medicare Parts A and B and have a current military ID card.
• Usually, there’s no out-of-pocket costs for services that both Original Medicare and TFL cover.
• TFL acts as a supplement to Original Medicare. There are no enrollment procedures or TFL premium payments. Members must continue paying the Medicare Part B monthly premium.
• TFL enhances benefits by eliminating out-of-pocket cost for many treatments. It also covers some things Original Medicare doesn’t like overseas medical care.
• Coordinates seamlessly with Original Medicare.
• Includes drug coverage. Home delivery discontinues if a member enrolls in a plan that includes prescription drug coverage.
• Members may have the option of purchasing standalone dental and/or vision coverage under the Federal Employees Dental and Vision Insurance Program (FEDVIP).
• Can see any provider who accepts Original Medicare.

Are Medicare Advantage HMO, PPO, and MA products a good fit for those with TFL?

Items to consider:

• Enrolling in an MA or MAPD will affect TFL coverage.
• TFL coverage is more comprehensive as it has no network requirements.
• When using an MA/MAPD plan, members must use the MA/MAPD’s plan network for all plan services.
• There are no TFL out-of-pocket costs. An MA/MAPD plan requires out-of-pocket payment of deductibles/copayments.
• TFL is always the secondary payer, or payer of last resort.
• If a TFL member has other health insurance (OHI), this includes an MA or MAPD plan, the OHI pays first, TRICARE pays last. TFL and OHI do not coordinate benefits. It’s up to the member to file claims for reimbursement.
• After OHI processes the claim, the member will have to file a paper claim with the TFL contractor, Wisconsin Physicians Service (WPS). WPS processes the claim and pays TFL’s portion of the claim.
• Claims must be filed within one year from the date of care.

We thank you for serving our country

We thank you for the time and dedication you put into serving our country. Our give back is ensuring you’re in a plan that fits your needs and budget.

We know Medicare can be confusing. So, we want you to know and visit Attain Health to gather more information about Medicare. At Attain Health there’s a team of experienced Medicare licensed insurance agents available through your Medicare options. Let one of these agents conduct a plan review for you at no additional cost. And with no obligation or pressure to enroll in a plan. We take pride in providing information and answering Medicare questions, so you’ll feel confident you’re in the right plan for YOU.

If after discussing enrollment with your TFL administrator, you feel it’s the right choice for you, our agents are more than happy to help.