Supplemental Health Care Plans; Tricare for Life May Obviate the Need

This is an issue for folks who are retired and under medicare Part B and Tricare for Life. Basically it finds that supplemental health care programs are unnecessary. It is an individual matter and decision. The post below may assist in your determinations.

When a Retiree is on TFL (Tricare for Life), Medicare is the primary health care insurance with Tricare as a no-cost, wrap-around coverage (basically a no-cost supplemental plan). Retirees pay for TFL out of their Social Security (if they are drawing Social Security) or directly to the Social Security Administration if they are still working or are simply waiting to draw their Social Security. When a Retiree or Spouse turns 65, they must leave traditional Tricare, whether Prime or Standard. By law, they cannot remain on either. To qualify for TFL, you must pay for Medicare Part “B” and update DEERS with your Medicare information. You don’t have to take part in TFL (by paying for Part “B”), but it would behoove you to do so (TFL is excellent health care, and the cost is much lower than other plans that offer similar coverage) as you will only have Medicare Part “A”, which only covers only hospitalization. Numerous Retirees have found themselves in a financial bind by using VA health care and military medical facilities instead of TFL, thinking they are saving the cost of Medicare Part “B”. But when they are moved from a military medical facility to a civilian hospital (due to severe illness or injury) there is no wrap-around coverage to pay for what Medicare Part “A” does not. This is not a situation you want to find yourself in.

Supplemental Health Insurance.

Supplemental health insurance, while providing peace of mind, does much the same as TFL, but at a cost. TFL payments consist of a payment that normally comes out of your Social Security, with Tricare providing wrap-around benefits at no additional cost. To determine where a supplemental health insurance plan could make sense, one has to look at their location and type of Tricare. If a Retiree is on Tricare Prime, there is no reason for a supplemental. Prime has an annual enrollment fee only and a catastrophic cap (maximum out-of-pocket) of $3000 per fiscal year. A catastrophic cap is the point where a Retiree’s responsibility for payment ends and Tricare picks up the bill for everything else. This means that one would have to pay the enrollments fee and a whole lot of pharmacy and physician cost-share dollars to even get close to the point where the Retiree would no longer pay the remaining charges. It is exceedingly unlikely the expenses of someone who is on Prime, would ever exceed $3000 in a year.

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