VA and TRICARE Benefits with Medicare

Some military Veterans and/or their spouses and children can and do receive additional healthcare coverage and benefits above and beyond traditional Medicare. 

This section is a synopsis of some the healthcare options some military Veterans can receive. If you are a Veteran, then you should contact the VA (Veterans Administration) to learn more.

TRICARE: Tricare is the health care program for uniformed service members, retirees, and their families around the world. If you are on Medicare and have TRICARE, then Medicare is your primary payor and TRICARE is secondary (like a Medicare Supplement) and includes your prescription coverage. When it comes to having TRICARE, you really have about the best healthcare insurance you can get. You do not need anything else…other than Long-Term Care. 

WARNING! 

The Downside To Combining Medicare Advantage and TRICARE

TRICARE and Medicare Advantage don’t always work well together. If you are on a Medicare Advantage Plan and also have TRICARE, then the Medicare Advantage Plan will be the primary payor instead of Original Medicare and TRICARE is secondary. 

The dangers of having TRICARE and Medicare Advantage  are:

1. Because most Medicare Advantage Plans utilize provider networks, your provider choices may be and likely will be more limited than having Original Medicare plus your TRICARE. 
2. Confusion over billing. Sometimes the provider doesn’t handle the billing properly and you may end up with a bill that should have been covered by TRICARE. If that happens, notify the provider to submit the claim to TRICARE as secondary. If you have TRICARE and a Medicare Advantage Plan, then the Medicare Advantage Plan is the primary payor and TRICARE is second.   Unfortunately, those with a Medicare Advantage Plan and TRICARE often end up being charged copays when TRICARE should be paying them. This shouldn’t happen, but it does. So, if you have TRICARE and a Medicare Advantage plan or you are thinking about it, please consider this and contact me for a thorough review.
3. Your Medicare Advantage Plan drug coverage may be inferior to your TRICARE drug coverage. Be sure to look into this if you want a Medicare Advantage plan. But, you may be able to get a Medicare Advantage plan that does not include drug coverage.

The Upside To Combining Medicare Advantage and TRICARE

You should know that there are some positives to having Medicare Advantage and TRICARE together. By having Medicare Advantage as the primary payor you may:

1. Have better managed care.
2. Greater benefits…like extra dental, vision, fitness membership, transportation and more.

VA Benefits: Qualifying Veterans can receive additional health and medical coverage through the VA. Such as:

• Access to VA clinics and hospitals for tests, procedures and surgeries.
• Excellent prescription drug coverage.

If you have VA benefits, then the right Medicare Advantage plan can be an excellent choice. You will receive additional benefits above and beyond Original Medicare and your VA benefits. Of course, contact me to discuss which Medicare Advantage plan might be right for you.

CHAMPVA Benefits: CHAMPVA is a health coverage program for certain military personnel, veterans and/or their spouses. It helps provide cost-sharing coverage for what Medicare doesn’t pay. CHAMPVA does work with Original Medicare and Medicare Advantage. For more info, go here.

To apply for VA benefits, see this link (https://www.benefits.va.gov/BENEFITS/Applying.asp) for more info.