As a retiree you have several health care benefits to choose from. These include VA provided medical benefits, TRICARE and other supplemental health care insurance options.
Retirees Can Receive Care at VA Facilities - Retirees continue to be eligible for Department of Veterans Affairs (VA) medical care on a space-available basis. There are many limitations and eligibility requirements. VA medical care should not be relied on as your only source of health care.
TRICARE: Health Care for Retirees
Retirees and their families remain eligible to use civilian health care facilities under TRICARE. TRICARE eligibility remains in force until you are 65 years old. Upon reaching age 65, TRICARE ends, and you become eligible for TRICARE for Life. For information on TRICARE, contact the Beneficiary Service Representative or Health Benefits Advisor at your nearest military treatment facility.
Find out more about TRICARE For Life (TFL) - TRICARE benefits for retirees age 65 and older.
TRICARE offers Retiree beneficiaries three options in obtaining medical care.
1. TRICARE Prime: This is a health maintenance organization-type managed care program for which retirees are required to pay an annual enrollment fee. Enrollees are assigned a primary care manager, who determines the most appropriate, available source of careâ€”either a military treatment facility or a civilian network provider. Enrollees pay little or no co-payment, and usually are not required to file claims for their care.
2. TRICARE Extra: This is a preferred provider organization-type program; no enrollment is required, however care has to be provided by a TRICARE network provider. You will be responsible for paying the annual deductible and cost shares at a reduced rate. The network provider will file your claim.
3. TRICARE Standard: This is a fee for service option that requires an annual deductible and cost shares after the deductible has been reached. Under TRICARE Standard you are responsible for filing your claim.
Beneficiaries should contact their Health Benefits Advisors/Beneficiary Counselor and Assistance Coordinators (BCAC) at MTFs or stop in at your TRICARE Service Center for more assistance. Locate the BCAC for your state.
TRICARE Retiree Dental Plan
The TRICARE Retiree Dental Program (TRDP) provides comprehensive dental coverage for Uniformed Services retirees and their family members. Under contract with the U.S. Department of Defense, the Federal Services division of Delta Dental Plan of California administers the TRDP.
The TRDP is a voluntary dental benefits program with enrollee-paid premiums.
Covered services under the TRDP are offered throughout the 50 United States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, the Commonwealth of the Northern Mariana Islands and Canada. Visit the TRICARE Retiree Dental Plan website for further information.
Supplemental Health Insurance for Retirees
One short stay in the hospital could offset the cost of several years of supplemental health insurance. Even though you are covered by TRICARE, a supplemental insurance policy is a good idea for retirees. Here's why:
If you are covered by health insurance with your new employer, you may use TRICARE as your supplemental insurance for that policy. Check with your TRICARE advisor concerning your particular circumstances.
TRICARE For Life
If a member or family member becomes entitled to Medicare Part A, whether due to a disability or when they turn 65, they are eligible for TRICARE For Life (TFL). There are no TFL enrollment fees, but you are required to pay Medicare Part B premiums (unless the sponsor is on active duty). When using TFL, TRICARE is the second payer after Medicare in most cases. Get more information about TFL.
Family members are entitled to TRICARE benefits as transitional survivors or survivors if their active duty service sponsor who died while serving on active duty for a period of more than 30 days. TRICARE pays transitional survivor claims at the active duty family member payment rate and pays survivor claims at the retiree payment rate for surviving spouses while eligible children claims process at the active duty family member rate. Transitional survivors pay no enrollment fees or co-payments when they use TRICARE Prime. They will, however, pay cost shares and deductibles at the active duty family member rate to use TRICARE Standard or TRICARE Extra.
Contact your TRICARE regional contractor for assistance.
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