How Medicare Works with TRICARE for Life

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If you have TriCare for Life or ChampVA it is my opinion and the opinion of the insurance company to which I have alluded, that you keep your TriCare or ChampVA, and keep Original Medicare. Do not trade your Medicare in for a Medicare Advantage Plan, do not trade your Tricare or ChampVA in for a Medicare supplement, and do not get a stand-alone Medicare Part D plan.
I believe you cannot improve on your healthcare by messing with your TriCare. If you replace your original Medicare with an Advantage plan you are actually reducing your insurance coverage and increasing your financial risk.
That’s the short answer. That’s my firm opinion.

Tricare For Life is Like a Medicare Supplement

For Tricare for Life to be active, you must also have original Medicare. That is Medicare Part A (inpatient coverage) and Medicare Part B (outpatient coverage). Original Medicare becomes your Primary insurer and with Tricare being secondary, just like a Medicare supplement plan. Tricare for life is premium free. You earned it.

The part of this that is most important and the reason I made this video is that Original Medicare, that red, white and blue Medicare card is your primary insurance.

Why is it important that original Medicare remain your primary insurance? Because you get to keep the benefits of original Medicare.

There are two benefits of original Medicare that are critical to your healthcare.
First, with original Medicare being your primary insurance, you are not limited to any network. You can see any doctor or visit any medical facility in the country as long they accept original Medicare. That’s pretty much every doctor and every medical facility in the US. or US territory. There are very few exceptions.

Second, no insurance company can interfere with your care. Your medical decisions are between you and your doctor. The goal of both Medicare and TriCare is to cover everything that is medically necessary. Your doctor does not need to get prior approval from the insurance company. You do not need to get a referral from your doctor if you wish to see a specialist. No insurance company can stall or prevent your medical treatment based on their internal rules. All medical decisions are between you and your doctor.

When you have Original Medicare, Tricare for Life and Medicare work hand in glove so that your annual maximum out-of-pocket financial risk is limited to near zero. In fact, the only expense for inpatient or outpatient services would be if TriCare approves a treatment that Medicare does not. I have never seen that, but I guess it’s possible. In that case TriCare will cover the service with a small potential out-of-pocket from you. Please see your TriCare benefit details online for specifics. I have a link to the government site below.

As I mentioned, TriCare for life is like a Medicare supplement Plan on steroids. In addition to the standard Medicare supplement benefits, your TriCare includes prescription drug coverage. You do not want to get a separate Medicare Part D plan. In fact, doing so can cause harm to your TriCare, especially ChampVA.
By the way, did you know that the drug coverage you have through TriCare is not subject to the expensive coverage gap that is a feature of Medicare Prescription drug coverage? You have no coverage gap, no donut hole like those with Part D have to deal with.

Tricare For Life & International Coverage

One of the enhanced benefits I like about TriCare is that it offers significant healthcare coverage overseas. Medicare only operates in the US and US territories. Some Medicare supplement plans offer limited emergency coverage if overseas. When you have TriCare for life and are visiting or have moved overseas, TriCare becomes your Primary Insurance for overseas healthcare. Very cool.



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