TRICARE Standard and
TRICARE Extra
TRICARE Standard is a fee-for-service option that allows beneficiaries to seek
care from any TRICARE-authorized non-network provider. TRICARE Extra is a
preferred provider option that allows beneficiaries to reduce out-of-pocket costs by visiting TRICARE network providers. TRICARE Standard and TRICARE Extra
are available to all TRICARE-eligible beneficiaries except ADSMs. Beneficiaries
are responsible for FY deductibles and cost-shares. Beneficiaries may see any TRICARE-authorized provider they choose, and TRICARE will share the
cost of covered services with the beneficiaries after deductibles are met.
TRICARE For Life
TRICARE For Life (TFL) is TRICARE’s Medicare- wraparound coverage available
worldwide to TRICARE beneficiaries regardless of age, provided they are
entitled to premium-free Medicare Part A and also have Medicare Part B. TFL is
available to all TRICARE and Medicare dual-eligible* beneficiaries, including retired
members of the National Guard and Reserve who receive retired pay, family
members, survivors of deceased sponsors, and certain former spouses. Dependent
parents and parents-in-law are not eligible for TFL, but may be eligible for
space-available care at an MTF. TFL coverage is effective the same day that a
beneficiary’s Medicare Part B coverage becomes effective.
Some beneficiaries entitled to premium-free Medicare Part A, including ADSMs,
ADFMs, and beneficiaries with TRICARE Reserve Select (TRS), TRICARE Retired
Reserve (TRR), Continued Health Care Benefit Program (CHCBP), and US Family
Health Plan (USFHP), may keep their current TRICARE benefits without Medicare
Part B coverage. Medicare allows certain beneficiaries, including ADSMs and
ADFMs, to sign up for Medicare Part B during a special enrollment period, which waives monthly Part B late-enrollment premium
surcharges. However, all beneficiaries are strongly encouraged to sign up for Medicare Part B as soon as they become eligible to avoid a break in
TRICARE coverage and Medicare monthly late enrollment premium surcharges.
Note: Beneficiaries age 65 and older who are not eligible for premium-free Medicare Part A may remain eligible for TRICARE Prime (if residing in PSAs) or TRICARE Standard and TRICARE Extra. Beneficiaries with only Medicare Part A or only Medicare Part B are not eligible for TFL. Medicare Part B coverage is recommended for TRICARE and Medicare dual-eligible beneficiaries enrolled in the USFHP or TRS, but it is not required. Refer to “Entitlement to Medicare and TRICARE” in the TRICARE Eligibility section of this handbook for more information.
No comments:
Post a Comment