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Tricare and Retirement

Tricare and Retirement

After you have retired from your post in the military forces, there is a change in the kind of coverage and support that TRICARE has to offer. Read on to learn more about TRICARE and Retirement with post-retirement health care plans.

Upon retiring from active service, there is a change in your status, as well as that of your family members. First and foremost, new ID cards will be issued to you and the members of your family. Secondly, there will be a change in the number of options that are available to you upon retirement. This is especially so if you relocate to another place. This does not mean that you will no longer be covered byTRICARE – TRICARE coverage will still be provided, so you can always be assured that all minimum essential medical health care services will be covered.

Available Health Care Plans

Once you retire from service in the military forces, you will automatically be removed from the TRICARE Prime plan. There are a number of ways in which you can now proceed. If you are living in an area that is catered to by the TRICARE Prime service, you have the option of registering for TRICARE again. Although active service members are not required to pay any enrollment fee, you will now have to do so on an annual basis. In order to register for TRICARE Prime again, you can contact TRICARE either over the phone or via mail. In order to make sure that there is no break in the coverage offered by this health care plan, you have to ensure that you re-enroll for the Prime health care plan within the first month (or thirty days) of retirement.

If you have registered for the TRICARE Prime health care plan, then your primary care manager will be responsible for dealing with all your routine health care services. In addition to this, like before, the primary care manager will also be responsible for providing you with any referrals that you may need in order to consult a specialist, as there are certain services that a regular doctor may not be able to provide. Since you will no longer be an actively serving member, you can only choose a primary care manager at a military clinic or military hospital if sufficient space is available (previously, as an actively serving member, you received priority at these facilities).

A number of other plans are now also open, and you and your family members may opt for one of those. These include the TRICARE Standard plan, TRICARE Standard Overseas plan and Tricare Extra health care plan. In certain locations in the United States, you will also have the option of enrolling for the US Family Health Plan, as well as the TRICARE for Life plan.

Which Services are covered by TRICARE?

After you have retired from your position in the military forces of the United States, there will be certain medical health care services that will not be covered by the TRICARE health care program anymore. This includes the provision of hearing aids and chiropractic care. With the exception of the TRICARE Prime plan, eye examinations will not be covered by TRICARE either. Furthermore, family members of the previously active service member will no longer have access to TRICARE Extended Care Health Options.

In order to make sure that any dental services that you may wish to avail in the future are also covered by TRICARE, you can opt for the TRICARE Retiree Dental Program.

What Costs Should You Expect

As an actively serving member of the military services, you did not have to pay anything out of your own pocket. Further, you probably incurred very minimal costs for the health care of your family. After you retire from the military forces, you can expect there to be an increase in the costs that you will incur. At the end of the day, the costs that you will have to pay for out of your own pocket depend on a large extent on the kind of health care plan you opt for. These new costs might include the annual enrollment fee for the TRICARE Prime health care plan. In addition to this, additional costs may crop up in the form of network co-payments if you have the TRICARE Prime health care option. The costs of using the TRICARE Standard health care plan or the TRICARE Extra health care plan also increase by approximately 5%. In addition to this, the catastrophic cap goes up from $1,000 to almost $3,000 for each family, which has to be paid on an annual basis.

However, if you are using any kind of medication, the costs of your prescriptions will not change.

Are Family Members Eligible?

In order for your family members to remain eligible for coverage by TRICARE even after you have retired from service, it is essential for them to be enrolled in Medicare Part B.

Medical Retirement

Even if you have retired from service on medical grounds, you can still have access to the benefits offered by the TRICARE system. In order to access these benefits, however, you have to be registered in either the Temporary Disabled Retirement List or the Permanent Disability Retirement List. Additionally, it may also be possible for members of your family to still have access to TRICARE health care plans in the capacity of being a retiree’s family members.

In case you suffer from any injury or chronic health condition, the Service will first try to evaluate and assess the health problem. It will then see whether you are in either of the aforementioned lists. Your disability will then be rated. If the Service gives you a disability rating that is below 30%, then you will be removed from your post in the military force. After this is done, you then have the option of applying for a temporary health care plan, such as the Transitional Assistance Management Program or the Continued Health Care Benefit Program. If you are covered by TRICARE or either of these plans, then this means that you have the essential coverage that is required in accordance with the Affordable Care Act.

Retirement from National Guard or Reserves

If you retire from your post in the National Guard or Reserves, there will be a change in the health options and dental options that you have available to you. The coverage provided by the TRICARE Reserve Select health care plan will no longer include you. So what options do you have now?

In certain cases, you and your family members may be considered eligible to register for the TRICARE Retired Reserve health care plan. If you are able to send in your application within one month of your retirement from the National Guard or Reserves, then you will be able to avoid any break or disruption in the coverage that is provided by this health care plan. Upon enrolling in the TRICARE Retired Reserve plan, you can be assured that the basic essential coverage that is outlined in the Affordable Care Act will be provided to you. However, you can also look around in the Health Assurance Marketplace – you may be able to find a civilian health care plan that is better suited to your needs and is also more budget-friendly and affordable.

So what happens when you turn 60? At the age of 60, you will retire from the National Guard or Reserves and you will begin to receive a retired pay. At this point, there are a number of different health care plans that you and members of your family will be eligible for. Ultimately, the plan that you opt for will largely depend on where you choose to live once you retire. Among the plans that you might have available to you at this point are the TRICARE Prime health care plan, TRICARE Standard health care plan, TRICARE Standard Overseas health care plan and TRICARE Extra health care plan. In addition to this, the TRICARE Young Adult health care plan is also available for those adult children who are still seen as dependents and who qualify for this particular plan. Other available plans include the US Family Health Plan and the TRICARE for Life health care plan.

As far as coverage for dental services is concerned, you and members of your family have the option of enrolling for the TRICARE Retiree Dental Program. The TRICARE Retiree Dental Program is designed in a way to provide comprehensive dental services to those who are enrolled in the program. It is a very affordable and cost-effect dental treatment plan. Enrollment for this program is, of course, voluntary. In addition to this, all those who register for the TRICARE Retiree Dental program will also be required to pay premiums. In general, it is suggested that if you wish to obtain coverage for dental services, then you should try to register for the program within four months (or 120 days) of your retirement. If you are able to enroll for the dental care plan within this time period, then you will not have to go through the regular waiting period, which can be up to 12 months long in duration for most major dental services.

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33 comments

  1. I received a bill from Quest Labs, they billed me for services after Tricare denied it. My question is can I mail the bill to you? I found out they did not use my late husbands social security number so you denied it. How can I fix this situation?

  2. My wife is over 65 and will like to purchase Tri Care for Life as a Co-pay instead of MEDCARE
    Need to compare quotes.

  3. I can find no info on Tricare for Life or how to plan for Medicare at age 65.

  4. Ralph & Debra Williams

    the doctor office asked for a Tricare card. How do we get a card to prove that we have Tricare?

  5. I’m just trying to make an appointment. There does not seem to be a place to do this.

  6. you say just log on tricare.com to get a appointment. WHAT DO YOU CLICK ON!!! Everything I click on just explains how it works.

  7. I received a letter from Health Net with a questionnaire “Tricare Other Health Insurance (OHI)” which said that my OHI information could be updated online at http://www.tricare.com. It is not clear where on that site this information can be updated. Please provide better directions.

  8. This wouldn’t be that bad if they left cnpmyaeots at $10 but not only did our premiums go up this year, but now we have to pay $20 for dr visits and $30 for brand name drugs instead of $20. I hate to think what our monthly costs will be next year.

  9. My question is can I be reimbursed for co-pays and if so how did I start this process? Where do I find the paper work? My husband is retired.

  10. I had battery replacement battery surgery for Deep Brain Stimulator (DBS) for the treatment of Parkinson’s Disease. Tricare North has refused to pay for it, calling procedure “experimental”. The cost for this is not trivial (over $11,000) for the doctor and over $50,000 for associated hospital costs. I received a letter from HNFS.com telling me that I don’t owe anything, but the doctor bills continue. The latest bill was 12/26/15, for $11,684.00. Your letter, dated 11/2/15 from Tricare/HNFS indicates I owe nothing. You indicate that the amount in question “is a contractual write-off” & I do not have to pay. Please help with this situation.

  11. I am currently overseas and am using Tricare. I will be heading back home to Wisconsin soon. How do I use Tricare back home? Now I use the Navy Hospital on base but I do not live close to a military base in Wisconsin.
    How do I get started in Wisconsin?

  12. Could I get a phone number to get some answers?

  13. I am a retired reservist age 64 and my wife will be 65 in three months. I currently have Blue Cross Blue Shield with Tricare as a secondary insurance. My wife will need to apply for Medicare now. Do I continue to use Tricare and do I need further supplements. I understand I will need to purchase Part B when I retire. Do I need to purchase part B for her at age 65? And do I need to purchase part c or D?

  14. William Shrewsbury

    What happened to TRICARE LIFE ?

  15. I want to sign in with tricare for life and print eob’s. How/where do I do that? TFL is secondary payee to Medicare for me. Thank you.

  16. how do I log into tricare for life? thank you.

  17. I retired from the U.S. Air Force in Dec 1992 after 20th years of service. I’m 67th years old and like to know if I have Tricare or do I need to apply for Tricare? I would like to talk to someone, but can’t find a phone number to call.

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