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Open Enrollment Time: Time for Retired Veterans with TRICARE/Medicare to Consider Medicare Advantage


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Should A Retired Veteran Expand to Medicare Advantage?

If you have turned 65 and are a retired veteran, you may want to look at some options for expanding your Medicare during the Open Enrollment period. You were likely issued Medicare’s hospital coverage (Medicare Part A) after turning 65. If you had TRICARE while you were still active in the military, you were likely told that regular coverage would end, but if you enrolled in Medicare Part B, Medicare’s medical coverage, you would be automatically enrolled in TRICARE for Life.

Having TRICARE in addition to your Medicare is a well-deserved privilege for your service to your country. You now have Original Medicare (Part A and B) and TRICARE. Let’s review how these two currently work for you.

Medicare serves as your primary payer. TRICARE pays second to Medicare or last if you have other health insurance. TRICARE benefits include covering Medicare’s coinsurance and deductible for services covered by Medicare and TRICARE. So if your Medicare plan covers 80% of a medical expense and you are supposed to pay the remaining 20%, TRICARE for Life will cover it. If your Medicare plan says you pay for the first $2,000 dollars of the cost of surgery before Medicare pays for the rest, TRICARE steps in to pay for the deductible out-of-pocket expense.

With your Medicare Parts A and B, you have what is known as Original Medicare. About 50% of Medicare patients continue to have this option. You only have a modest Medicare B premium from your monthly SSI check unless your income crosses a particular level.

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Should You Expand Your Original Medicare with Medicare Advantage?

You can enhance the services you receive by enrolling in Medical C (Medicare Advantage) or Medicare Part D for prescription drug coverage. Medicare C was created as a way for private health insurance companies to contract to provide you with all your Medicare Parts A and B benefits. Most plans include drug coverage under Medicare Part D.

Several Medicare Advantage plans from large healthcare insurance providers say they were designed with veterans in mind. A Medicare Advantage program can supplement your VA benefits by letting you use healthcare providers and hospitals outside the VA system, which may be closer to home, especially in an emergency. And if you have Medicare Part D included in your plan, you can get your prescriptions from your local in-network pharmacy. And remember, with your TRICARE for Life, your prescription copay will be covered. Some Medicare Advantage plans are covered by your present Medicare B premium. Some will require you to pay an additional premium. If there is an additional premium, weigh it against what you will gain,

There is a limited time per year when your existing Medicare can be changed. This is called the Open Enrollment period. Medicare Open Enrollment in California for 2024 is from October 15 to December 7.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options