Since 01-12-07
Staying in Tricare at 65
requires Medicare Part B
Since 01-12-07
From: Waspscpo@aol.com
Sent: Wednesday, November 08, 2006 4:01 PM
To: undisclosed-recipients:
Subject: Staying in Tricare at 65 requires Medicare Part B
http://www.tricare.osd.mil/eenews/
Tricare Help
Staying in Tricare at 65 requires Medicare Part B
November 13, 2006 Issue
Army Times
By James E. Hamby Jr.
Special to the Times
Q. I’ll be 65 in January, but I want to hold off enrolling in Medicare Part B. I
plan to work for a few more years and I have free health insurance from my job
as long as I continue to work. Medicare says I don’t have to enroll in Part B
for as long as I work and have insurance through my employer.
If I use plain Tricare as a supplement to my employer’s health insurance like I
do now, I won’t need Part B or Tricare for Life. I very seldom have anything
more to pay after Tricare pays, and I’m sure it’s less than Part B would cost.
What do you think?
A. Two rules involving Medicare Part B enrollment are sometimes confused. One is
a Medicare rule; the other is a Tricare rule. Although both deal with Part B,
their effects are unrelated.
• The Medicare rule concerns deadline dates for Part B enrollment and the
penalty for late enrollment, when a person becomes entitled to Medicare Part A.
It concerns the amount of one’s Medicare Part B premium only.
• The Tricare rule concerns the requirement for Part B enrollment when a Tricare
beneficiary becomes entitled to Medicare Part A. Failure to enroll in Part B
causes loss of Tricare eligibility until the beneficiary enrolls in Part B.
The rule described in your letter as part of your plan is a feature of Medicare
law. It establishes times for Part B enrollment that depend on the Medicare
beneficiary’s work status with an employer that provides health insurance. It
also establishes the penalty amount for late enrollment according to that “work
rule.”
If we omit the Medicare Part D pharmacy program that Tricare beneficiaries don’t
need anyway, Medicare consists of two basic programs: Part A, hospital
insurance, and Part B, medical insurance.
In general terms, Part A covers services a hospital provides, such as room and
board, nursing services and use of radiology and laboratory facilities. Payment
must go to the hospital.
Part B covers doctors’ and other individual providers’ services. Payment is sent
to the doctor or other individual provider.
To learn the details, call Medicare at (800) 633-4227 or go to the official
Medicare Web site at www.medicare.gov.
Medicare Part A is free. When a person enrolls in Part A, he has a grace period
for enrolling in Part B. If he misses the deadline for Part B, he will have to
pay a penalty on his Part B premium for the rest of his life.
However, if the person has “creditable” health insurance — meaning coverage at
least as good as Medicare — through employment, enrollment may be delayed
without penalty for as long as the person continues to work for that employer.
That is a Medicare rule. It relates only to the premium penalty for late
enrollment in Part B. It is unrelated to Tricare.
Here is the Tricare rule you overlooked that will keep your plan from working:
The 1966 law creating what now is called Tricare contains a provision that
applies to all Tricare beneficiaries except active-duty family members; it says
Tricare beneficiaries who become eligible for Part A of Medicare cannot keep
their Tricare eligibility unless they also enroll in Part B. And there is no
grace period.
You will become entitled to Medicare Part A at age 65. You will not incur a Part
B late-enrollment penalty for as long as you work for an employer that provides
creditable health insurance. But you will lose all Tricare eligibility if you
are not enrolled in Part B on the date your Part A coverage becomes effective.
One second into the first day of the month of your 65th birthday, your Defense
Enrollment Eligibility Reporting System record will be changed automatically to
report you as ineligible for Tricare. The only way to prevent it is to be
enrolled in Part B at that moment.
Without Part B of Medicare, you will be ineligible for Tricare. But your Tricare
eligibility will be restored automatically as soon as DEERS receives official
notification you are enrolled in Part B.
When you are enrolled in both parts A and B of Medicare and eligible for Tricare,
you have coverage under the program called Tricare for Life.
If you are still working at that time, your employer’s health insurance will be
your primary coverage. Medicare parts A and B, not Tricare, will be your
secondary health insurance. Tricare will be your last payer on claims, as
required by law.
When you are no longer working, Medicare parts A and B will become your primary
health care coverage.
James E. Hamby Jr. may be reached by writing to Tricare Help, Times News
Service, 6883 Commercial Drive, Springfield, VA 22159; or by sending e-mail to
tricarehelp@atpco.com. In e-mail, please include the word Tricare in the subject
line and do not attach files. If using regular mail, please include an e-mail
address if possible to prompt a faster response.
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Contributed,
YNCS Don Harribine, USN(ret)