Keeping health insurance in place throughout different life stages is crucial for the well-being of both you and your family. If you or a family member qualifies for tricare for life, you might be wondering how one person’s TFL coverage influences TRICARE coverage for others in the household.
“There are several aspects that contribute to qualifying for TFL. One key factor is being entitled to Medicare,” explained Anne Breslin, who manages the TRICARE For Life program for the Defense Health Agency’s TRICARE Health Program. “Eligibility for Medicare can depend on age or, for those under 65, if they have a qualifying illness or disability. This means they can receive Social Security Disability Insurance benefits and then Medicare. Therefore, if one family member becomes eligible for TFL and Medicare, it doesn’t alter TRICARE enrollment for other family members; everyone can stay in their current TRICARE plan.”
Here are some common questions that sponsors or family members approaching TFL and Medicare eligibility might have.
What does TFL cover? According to the Tricare and Medicare brochure for those turning 65, TFL serves as Medicare’s supplementary coverage. TRICARE and Medicare collaborate to lower out-of-pocket expenses.
A beneficiary’s TFL coverage does not extend to family members. If your family qualifies for TRICARE, each member will maintain their own TRICARE health plan.
Who is TFL for? TFL is designed for uniformed service retirees and their families who are eligible for TRICARE and enrolled in Medicare, including Part A and Part B. TFL coverage is activated automatically only once.
Make sure to keep your family’s contact information current in DEERS.
Is Medicare guaranteed at age 65? Not necessarily. There are qualifying life events for those turning 65. However, for families with members under age 65, qualifying changes to their TRICARE health plan are possible within 90 days of the Medicare-eligible family member’s effective Medicare date.
If you want more information, check out resources about being covered by Medicare.
Can families without Medicare stay on TRICARE? Yes, as long as they meet TRICARE eligibility requirements, they can continue with their current health plan.
It’s important to have both Medicare Part A and Part B to be eligible for TFL coverage. This applies to individuals even if they live overseas or have employer-provided insurance.
Did you only enroll in Medicare Part A during your sign-up period? If so, you can still register for Medicare Part B during designated special enrollment or general admission periods. For instance, if you opted for employer-provided health insurance instead of Medicare Part B, you can apply for Part B during the special enrollment period. This period covers:
- If you or your spouse have employer-sponsored health insurance
- Up to 8 months after losing that employer-sponsored insurance
It’s wise to sign up for Medicare Part B a month before your employment coverage ends. This ensures you have ongoing coverage with Medicare Part A, Part B, and TFL after your employer’s insurance lapses.
Be sure to consult the Tricare for Life Handbook to learn more about options for signing up for Medicare Part B.
What if my family member is on TRICARE Prime or Select? Enrollment fees are variable; for example:
- If only one family member is enrolled in TRICARE Prime or Select, the fee will be adjusted to an individual rate.
- If two or more family members enroll, the fee will switch to the family rate.
For understanding your health insurance costs, and other related information, you can refer to TRICARE’s resources or contact the TRICARE Regional Contractor.
What happens if my sponsor passes away after retirement? You can still qualify for TRICARE unless you remarry (except if your new spouse is a veteran). If you’re the surviving spouse enrolled in both Medicare Part A and Part B, you can secure TFL coverage.
What resources does TRICARE offer?
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