Department of
Insurance

Tricare For Life

The TRICARE for Life program went into effect on October 1, 2001 and the pharmacy benefit program became effective April 1, 2001.

Who is Eligible?

Uniformed services retirees who served at least 20 years in the military (including retired members of the National Guard and the reserves), their family members and survivors, and some former spouses (who have not remarried) are eligible for expanded medical coverage through TRICARE for Life and the TRICARE Senior Pharmacy Program.

In order to be eligible for TFL, you must be eligible for Medicare Part A and enrolled in Medicare Part B.  You may not purchase Part A.  If you must buy into Part A, you will remain in the Tricare Standard Program.

If you do not have Part B, and you are just becoming eligible for Medicare (at age 65 or as a result of disability), you must ensure that you have signed up with Social Security and indicated that you want Part B.  Retirees who elected not to take Medicare Part B when they first became eligible can sign up through their local Social Security office during the Medicare general enrollment period (January 1 through March 31 of any year); their Medicare Part B coverage will start the July of the year they sign up.

(For instance, if you sign up in February, 2002, your Medicare Part B coverage will start in July, 2002.)  It is important to note that retirees may be charged a penalty (10 percent per year) for enrolling past their initial enrollment period.  Call the Social Security Administration at 1 (800) 772-1213 for more information about enrollment in Part B and any penalties that might apply.

To be eligible for the new Tricare programs, military retirees must be registered in the Defense Eligibility Enrollment Reporting Systems (DEERS), and their information must be up to date.  You can update DEERS information in one of the following ways:

• Make changes on the Web site: www.tricare.osd.mil/DEERSAddress/
  

• Fax changes to Defense Manpower Data Center Support Office, Attn:  COA, fax number 1 (831) 655-8317

• Mail changes to:  Defense Manpower Data Center Support Office, Attn:  TRICARE for Life, 400 Gigling Road, Seaside, CA  93955-6771

• Call the toll-free number at 1 (800) 538-9552

Enrollment in TRICARE for Life and the Tricare Senior Pharmacy Program is automatic for individuals who meet all the eligibility criteria listed above and have a military ID.  There is no application process, and there are no fees for enrollment.

The new TRICARE programs essentially operate like a supplemental insurance policy, covering many Medicare deductibles and co-payments as well as additional hospital, inpatient mental health care and skilled nursing facility care.  They also offer additional services such as prescription drug coverage and health-care services received outside the United States.

There are no premiums for the Tricare programs although beneficiaries must still continue to pay their Medicare Part B premiums ($54 per month in 2002).  Tricare will cover the $100 Medicare Part B deductible.

No.  Any doctor who is a Medicare-approved provider will also be deemed an authorized Tricare provider.  There is no separate credentialing process for becoming a Tricare provider.  If your client’s doctor does not accept Medicare assignment, Tricare will pay up to 115 percent of the Medicare-allowed amount.

TRICARE is a secondary payer to Medicare under most circumstances.  This means that Medicare pays first, and then Tricare will pay most other costs, including co-payments and deductibles, for the benefits that it covers.  If, however, a beneficiary has some other type of health insurance (such as a Medigap plan or employer-sponsored health insurance) in addition to Medicare and Tricare, then that other insurance will be the secondary payer to Medicare, and Tricare will pay any remaining costs for covered services (Medicare pays first, the other insurance pays second and Tricare pays third).

For more information about your benefits please call:

TRICARE for Life:  1-888-DoD-LIFE (1-888-363-5433)

Tricare Senior Pharmacy:  1-877-DoD-MEDS (1-877-363-6337)

For the hearing impaired (TTY/TDD): 1-877-535-6778