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TRICARE FOR LIFE VS FEHB

Posted 5/1/2013 Printable Fact Sheet

TRICARE for Life (TFL) is a civilian-based health care plan and available to all Medicare-eligible TRICARE benefits regardless of age, provided the member has Medicare Parts A and B. Medicare is the primary insurance and TFL acts as the secondary, supplemental insurance. In coordinating TFL with other health insurance, Medicare pays second and TFL is always the last payer.

There are no enrollment fees for TFL, but the Medicare Part B monthly premiums must be paid by the member (Part B premium is based on income.) There are no out-of-pocket expenses for services covered by both Medicare and TRICARE; however, if one or the other does not pay, the member is responsible for the remainder. If the member does not sign up for Medicare Part B when first eligible, there is a 10 percent premium surcharge to have Part B added at a later time.

If the member has both Medicare Part A and Part B, then TFL is a wise choice. Coverage is available worldwide and the member may choose any provider. Medicare entitlement begins at age 65 and TFL coverage is effective the same date that the Medicare Part B becomes effective.

Federal Employees Health Insurance (FEHB) coverage may be suspended in order to use TFL. FEHB Program plans have as good or better coverage than Medicare. The member may change FEHB enrollment to any available plan or option at any time beginning 30 days before becoming eligible for Medicare. This enrollment change opportunity may only be used once, or during the annual Open Season, or because of another event that permits enrollment changes (such as a change in family status). The FEHB plan brochure (specific to each state) provides information on how its benefits are coordinated with Medicare. Some HMOs participating in the FEHB are structured to provide more comprehensive coverage if enrolled in both their HMO and their Medicare Advantage plan.

For additional information on Medicare Part B premiums visit: www.medicare.gov or contact the Social Security Administration at 800-772-1213.
For additional information on (FEHB) contact the Office of Personnel Management Retirement office at 888-767-6738 or visit the web site www.opm.gov/insure/health.

It is recommended members contact these agencies for current premium rates and compile a cost and benefit comparison between the two, and to check with personal health providers to determine which coverage is accepted at their facility.


Phone
Total Force Service Center-Aurora
(800) 525-0102 // DSN 847-3294





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