Medicare and Tricare are both government-run healthcare programs. They offer similar benefits, but there are some key differences. In 2022, these two programs merged into a single program. Here’s what you need to know about how they will work together!
Medicare and Tricare Enrollment
For members who have both Medicare and Tricare. Medicare will start automatically for them. If you are just with the Tricare program. You will need to sign up for the new program.
Covered Through Tricare
The new program will cover all of the benefits currently offered by both plans. This includes hospitalization, doctor’s visits, prescription drugs, and more.
How Will the New Program Work?
The new program will be run by the Centers for Medicare and Medicaid. CMS is a federal agency that oversees both Medicare and Tricare. The agency will work with state and local governments to provide benefits to enrollees.
The new Medicare-Tricare program will offer comprehensive coverage to enrollees. If you are currently enrolled in both programs, you will be automatically enrolled in the new program. If you are only enrolled in one of the programs, you will need to sign up for the new program.
You can remain eligible for Tricare without enrolling in Medicare Part B if you are:
- An active duty service member
- An Active duty family member
- Enrolled in Tricare Reserve Select, Tricare Retired Reserve, Tricare Young Adult, or the US Family Health Plan
It’s important to understand this. Make sure you enroll in Part B when you become eligible. You may lose eligibility for any TRICARE benefits if you don’t have it when it’s required.
When you become Medicare eligible, multiple factors are considered. The age of your spouse and covered family members, as well as the TRICARE plan you all were on are all factors.
Tricare for Life and how it works with Medicare
Medicare alone does not cover everything. Therefore, TRICARE for Life acts as a secondary payer to Medicare. You must have both Medicare Parts A and B to be eligible for TRICARE For Life coverage and it is available worldwide.
There are no enrollment fees. You will pay an annual deductible as well as cost-shares (copayments or coinsurance) for covered services.
Here’s a brief overview of how it works:
- You receive care from any Medicare-participating provider.
- You submit your red, white, and blue “Medicare” card and your TRICARE For Life beneficiary ID card to the provider.
- The provider files a claim with Medicare.
- Medicare processes and pays its portion of the claim.
- TRICARE For Life then processes and pays its portion (secondarily).
- You may get a bill for the provider’s charges not covered by Medicare or TRICARE For Life, such as deductibles and copayments.
- You can get more information about this coverage on the TRICARE website.
Do they cover Chiropractic?
While Medicare does not cover chiropractic services, Tricare does. To be eligible for this benefit, you must be enrolled in a Tricare health plan and have a referral from your primary care physician. Once you have a referral, you can see any licensed chiropractor who accepts Tricare. There is no limit on the number of chiropractic visits you can make, and there is no deductible or copayment.
Which one will they cover Dental?
Dental coverage is not included by either Medicare or Tricare. However, some dental plans will offer discounts to Medicare and Tricare enrollees. You can find these plans through the same process as any other dental plan.
How does Tricare and Medicare Cover Vision?
Medicare does not cover routine vision services, such as annual eye exams. However, Medicare will cover some vision services if medically necessary. Tricare does not cover routine vision care. It will cover medically necessary services.
Will both plans cover Hearing?
Medicare will not cover routine hearing exams or hearing aids. Tricare also will not cover routine hearing exams. It will cover hearing aids if they are considered medically necessary.
Does Tricare and Medicare Cover Prescriptions?
Medicare Part D covers prescription drugs, and you can enroll in a Part D plan even if you have Tricare. Tricare also has its own prescription drug coverage, which is separate from Medicare. You can enroll in a Tricare pharmacy plan even if you have Medicare Part D.
If you have Tricare and need help with vision and dental, please contact us for assistance.