Social Security & Medicare Q&A: Medicare TRICARE Benefits

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Social Security & Medicare Q&A: Medicare TRICARE Benefits

Q: If I choose not to apply for Social Security until I am 70, then am I also not eligible for Medicare until I am 70? If I do not get Medicare will my TRICARE benefits still apply until I am 70?

A: If you’re entitled to Social Security, then you’ll be eligible for Medicare at age 65 — regardless of when you start Social Security benefits. In fact, to retain your TRICARE For Life benefits, the health care coverage for uniformed-services retirees, you’re required by law to enroll in Medicare Part B (doctor’s and outpatient services). TRICARE serves as a supplement to Medicare, paying the Medicare deductible and patient cost share as well as offering pharmacy benefits.

Delaying enrollment when you first become eligible at age 65 for Medicare Part B is rarely advisable for most retirees because Medicare assesses a late-enrollment penalty, which the TRICARE For Life website calls a “premium surcharge,” of 10% for each full 12 months enrollment is delayed. This was a nasty surprise for veterans who were led to believe they would have access to health care through military and veteran’s facilities. Many veterans did not sign up for Medicare immediately when they turned 65 and found themselves without health care, and then higher Medicare premiums.

A new law, that was supported and lobbied for by TSCL, protects TRICARE beneficiaries by waiving the Medicare Part B premium late-enrollment penalty and establishing a special enrollment period. According to the TRICARE web site, beneficiaries who are entitled to Medicare Part A, but are not yet enrolled in Medicare Part B, will be automatically enrolled in Medicare Part B without a late-enrollment penalty during a special enrollment period that will continue through December 31, 2004. Those beneficiaries will receive a form by mail explaining their options.

Beneficiaries whose current Medicare Part B entitlement began between January 2001 and December 2004 and who are paying a late-enrollment penalty (more than $66.60 a month) will have their Part B premium reduced to the 2004 rate of $66.60 beginning January 2004 or if later, the Part B entitlement date. In early fall these beneficiaries will receive a refund for any excess premium penalties they paid beginning in January 2004.

This new law was a provision of the new Medicare prescription drug bill. Waiving the late enrollment penalty is one positive provision of the new law that rights a wrong for our nation’s retirement military personnel. Given so many of our servicemen and women are once again putting their lives on the line, it is only fitting that this injustice is corrected now.

For additional information about TRICARE For Life and Medicare visit the web site at http://www.tricare.osd.mil/TricareHandbook/default.cfm http://www.tricare.osd.mil/medicare/default.cfm or call 1-888-DOD-LIFE (1-888-363-5433).

September 2004