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Tricare Help: Is retiree stuck with bad plan, or can he switch to Tricare for Life?

May. 17, 2012 - 11:44AM   |   Last Updated: May. 17, 2012 - 11:44AM  |  
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Q. I have a friend who is an aging, retired Army colonel. After his long military service, he worked for an insurance company from which he is also now retired — with truly lousy retirement benefits. My wife and I told him about the benefits we get from Medicare and Tricare For Life. Can he "renounce" that other retirement health plan that has such skimpy benefits, and enroll in Tricare For Life?

A. The short answer is yes, your friend can give up his current plan and use Tricare for Life.

Not only can he do that, he should do that.

As with any health care plan, Tricare has complex rules that can sometimes be frustrating to deal with. But there is no question that Tricare provides robust health care coverage and is one of the lowest-cost health care plans in the nation, particularly for Medicare-eligible beneficiaries over age 65.

As you mentioned, for Medicare-eligible military retirees, Tricare For Life acts as a virtually free supplement to Medicare (although as many retirees will point out, TFL is not entirely free, since you must be enrolled in Medicare Part B, and paying the monthly Part B premiums, to be eligible for TFL).

There's one potential wrinkle in your friend's case: If he did not sign up for Medicare when he first became eligible at age 65, he will have to pay a penalty to enroll late in Medicare Part B. The penalty adds 10 percent to the Part B premium for each year that the individual delayed Part B enrollment after becoming entitled to Part A, and that penalty must be paid for life.

Your friend should contact the Defense Enrollment Eligibility Reporting System at 800-538-9552 for more information and to start registering for TFL.

Q. Like many of your readers, I understand the basics of Tricare. What I don't understand is how "Part D" works for prescriptions. Can you briefly address that?

A. Part D is not a Tricare program — it's the prescription drug program under Medicare. The consistent advice from the Defense Department's Office of Health Affairs is that virtually no one who is eligible for Tricare for Life — which you will be when you turn 65 — needs Medicare Part D prescription drug coverage.

Out-of-pocket co-pays for prescription drugs under Part D are usually higher than under TFL. Moreover, enrollment in Part D will preclude your use of the Tricare Mail Order Pharmacy program, under which you can get a 90-day supply of drugs for the same price that you would pay for a 30-day supply from a local retail pharmacy.

The Defense Department advises that the only people who might benefit from Part D coverage are those whose incomes are so low that they qualify for financial aid to pay their Medicare Part B premiums.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com?subject=Tricare%20Help:%20Is%20retiree%20stuck%20with%20bad%20plan,%20or%20can%20he%20switch%20to%20Tricare%20for%20Life?">click here to email us. In email, include the word "Tricare" in the subject line and do not attach files. Get Tricare advice anytime http://www.militarytimes.com/tricarehelp">on our blog.

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