Q. I am a "gray-area" retiree who will turn 60 soon and become eligible to start using my military retirement benefits. I am already on Medicare. When I turn 60, will I go right onto Tricare for Life? And what are my costs? Also, my wife is 55; what are her options and costs?
A. If you are on Medicare younger than age 65 due to disability, then yes, you will go directly to Tricare for Life when you leave the "gray area" and become entitled to full military retirement benefits. Under Tricare for Life, Medicare acts as first payer and Tricare Standard acts as second payer. To use the Tricare portion of your TFL benefit, you must be enrolled in Medicare Part B, the premium-based outpatient insurance. That costs about $100 a month for most beneficiaries. There is no enrollment fee for Tricare Standard, so the only other costs would be any minor applicable co-pays and cost shares for your care.
Once you become eligible for military retirement benefits, so will your wife. As she is still a decade away from qualifying for Medicare, she can choose any of the other Tricare options — Prime, Standard or Extra. You can get more information on those plans here: www.tricare.mil/Plans/HealthPlans.aspx
You can directly compare features of the different plans here: www.tricare.mil/Plans/ComparePlans.aspx
You can directly compare the costs of the various Tricare plans here: www.tricare.mil/Costs.aspx
When your wife becomes eligible for Medicare and signs up for Part B, she will also shift to Tricare for Life, with Medicare as her first payer and Tricare Standard as her second payer.
Q. My husband is active-duty military and we were just married a few months ago. I've been working on getting my name changed — what a hassle — and getting enrolled in DEERS, but we haven't been able to yet, so I'm not enrolled in Tricare yet. We want to start trying to get pregnant. If I got pregnant before I'm in DEERS and under Tricare, would the pregnancy be covered, or would we have to pay out of pocket? He's under the impression that I wouldn't be covered even though we're married.
A. Properly enrolling in DEERS and obtaining a military ID card are requirements to use Tricare benefits. As such, Tricare would not cover any care related to a pregnancy before you were properly enrolled in DEERS, even though you are married to an active-duty Tricare beneficiary.
The good news is, Tricare places no limitations on coverage of "pre-existing conditions." So if you were already pregnant at the time you enrolled in DEERS, your pregnancy-related health care needs would be covered from then on.
You can engage DEERS by visiting the ID Card/DEERS office on any military installation. You can also get general information from the main DEERS support office in California at 800-538-9552.
Email tricarehelp@militarytimes.com. Include the word "Tricare" in the subject line and do not attach files. Get Tricare advice any time at http://blogs.militarytimes.com/tricarehelp/.
