Tricare For Life is one of many healthcare benefit programs offered by the United States Department of Defense Military Health System.
Tricare provides civilian health benefits for active and retired military personnel and their dependents. Some members of the Reserve Component are qualified to receive Tricare benefits as well.
Historically, Tricare was known as CHAMPUS: the Civilian Health and Medial Program of the Uniformed Services.
In the years following World War II and the Korean War , more and more veterans needed healthcare for themselves and their families.
If you take into account the increased demand of veterans needing healthcare combined with the expansion of active military due to the the Cold War, it is no wonder the traditional, military provided healthcare system could no longer meet the needs of its members.
CHAMPUS was the answer to that problem.
Congress passed the Military Benefits Amendments of 1966 which worked along side the Dependents Medical Care Act of 1956. This legislation allowed the Secretary of Defense to contract with civilian health care providers to meet the increased demand.
In 1993, as a result of the requirements laid out in the Department of Defense (DoD) Appropriation Act for Fiscal Year 1994, the DoD announced plans for a nationwide managed care program for military personnel and their dependents, active and retired. This program became known as Tricare
After October of 2013, Tricare was no longer managed by the Tricare Management Activity under the direction the Assistant Secretary of Defense.
Currently, Tricare is managed by the new Defense Health Agency. In the past, the United States was divided into twelve regions that managed Tricare coverage. Sine then, it has been dramatically simplified into Tricare East and Tricare West.
What is Tricare for Life?
Congress enacted Tricare for Life as a response to complaints by beneficiaries who were having trouble paying their out-of-pocket Medicare costs.
Many on Capital Hill saw the need for a military healthcare benefit plan that would cover these out-of-pocket expenses instead of military retirees being required to purchase Medicare Supplemental Coverage.
Tricare for Life, also known as TFL, provides comprehensive health care coverage for retired military. TFL allows you the freedom to seek medical care from both Medicare-participating providers and/or non-participating providers.
Unless you have other health care coverage, once Medicare has paid its portion, the claim is automatically sent to Tricare for processing. Tricare for Life pays after Medicare and other coverage has paid its portion.
Out-of-Pocket Expenses to Expect with Tricare for Life
There are no enrollment fees with Tricare for Life, but you must pay a monthly premium for Medicare Part B. That premium will be based on your income.
Services covered by both Medicare and Tricare will have no out of pocket costs. That being said, there are costs associated with Tricare for Life:
Will the 2018 Changes Effect Tricare for Life?
Nearly all Tricare coverage plans will face sweeping changes this year (2018). However, Tricare for Life coverage will remain almost completely unchanged.
The reason that Tricare for Life will not be effected by the sweeping changes of Tricare coverage is that Tricare for Life works with Medicare Part B as wrap-around, health insurance coverage.
As we discussed, Tricare for Life includes an annual deductible that users must pay out-of-pocket when receiving care.
The major change is that, instead of that deductible resetting every October 1st, the deductible will reset every January 1st. This will bring the Tricare deductible calendar in line with most healthcare providers in the country.
How Tricare for Life and Medicare Work Together
You must have both Medicare Part A and Medicare Part B to be eligible for Tricare for Life coverage.
Medicare Part A is premium free health insurance policy for most people. Part B does charge a monthly premium. Both plans have additional costs for deductibles, copays and any coinsurance. It is because of the increasing costs of deductibles and copays for Medicare recipients that Tricare for Life is an excellent health insurance option for retired military personnel.
Tricare for Life is Medicare wraparound coverage. It has a prescription drug benefit, so you may not need a Medicare Part D plan. Don’t worry. If you have Tricare for Life, and eventually decide you want to enroll in a Part D plan, you can — at any time.
Tricare for Life Coverage Limitations
Like any healthcare insurance plan, Tricare coverage has its limitations. For example, Tricare does not cover chiropractic care (because it cannot be administered in a doctor’s office or a hospital). Tricare does not cover abortions, emergency contraceptives, or any cosmetic surgery. It does not cover non-surgical treatment for weight loss, or over-the-counter products that help you quit smoking.
Probably the biggest downside is that Tricare does not cover dental work.
Am I Eligible for Tricare for Life?
Who is eligible for Tricare for Life?
Regardless of your age, you are available for Tricare for Life if you are entitled to Medicare Part A and have Medicare Part B. The following list is a general breakdown of the Tricare for Life eligibility requirements:
There are always exceptions to eligibility. So, check with your regional contractor for additional exemptions.
What If I Am Not Eligible for Tricare for Life?
Other than Tricare for Life, there are several health care benefit programs available under the Tricare system.
Questions about Tricare for Life? Get in Touch Here
If you have any questions about Tricare for Life, or other health care benefits available under Tricare, contact one of the regional offices or regional contractors. In most cases, you will contact your regional contractor. However, if you are looking for Prime Travel Benefits approval, eligibility requests for Tricare Prime Remote, or need to resolve an issue with your regional contractor, you should contact your Tricare Regional Office.
- Tricare East Regional Contractor (Humana Military): 1-800-444-5445
- Tricare West Regional Contractor (Health Net): 1-844-866-9378
- Tricare East Regional Office: 1-844-204-9351
- Tricare West Regional Office: 1-800-558-1746
