Tricare For Life and Medicare Advantage

By Marc Manor

Until very recently, I believed that retired military personnel using their Tricare For Life benefits would not have a need for Medicare Advantage plans; however, because of the numerous additional benefits available in many Medicare Advantage plans, I have come to realize that Medicare Advantage may bring additional value and healthcare options to my retired Veteran brothers and sisters when used in conjunction with Tricare For Life.

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First let’s talk about Tricare For Life.  Tricare For Life is a benefit earned by those career military personnel who are “retired” from the military.  It is considered “wrap-around” coverage for those retired military who have both Medicare Parts A and B.  While there is typically a monthly premium for Part B, there is no charge for the Tricare For Life wrap-around coverage for those who qualify.

While in many ways, Tricare For Life works similar to Medicare Supplement Plan F (the most comprehensive Medicare Supplement plans), yet it is different because one cannot use a Medicare Supplement plan in conjunction with Medicare Advantage (Medicare Part C).  Hence the term “wrap-around coverage”!  The reason this is so significant is because retired military members with Tricare For Life can use their benefit in conjunction with Medicare Advantage and therefore have three layers of Medicare insurance coverage!

Why have multiple layers of Medicare healthcare coverage you ask?


Additional Benefits. Tricare For Life pays claims only on things covered by original Medicare.  This does not include things like routine chiropractic or acupuncture services, fitness club memberships, dental coverage, and Over the Counter (OTC) benefits included in many Medicare Advantage plans.

Coordinated Payment of Medicare Covered Claims.  Medicare Advantage Plans typically have co-pays and co-insurance that are set on a benefit schedule.  These co-pays/co-insurance vary depending on the service.  If someone has Tricare For Life, many of the co-pays/co-insurance costs will be paid by Tricare For Life as the third payer as long as those services are covered by original Medicare and Tricare For Life.*  So what that generally means is that the only co-pays you would be responsible for as a Tricare For Life beneficiary are for things that would not be covered at all if the beneficiary did not have the Medicare Advantage Plan.

*While most providers are very efficient at filing claims with multiple layers of Medicare/healthcare insurance coverage, some have failed or are unwilling to file claims to Tricare in conjunction with Medicare Advantage Plans.  If this occurs, it is possible that the beneficiary may have to submit "after-the-fact" claims to Tricare for Life.  If the claims are for services covered under Original Medicare, then they would be paid/reimbursed but it may cause some inconvenience on the part of the beneficiary (filling out and mailing forms etc.).

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"Win-Win" Proposition.  It can really be a win-win because the many of the Medicare Advantage Plans have a zero premium and any coverage that overlaps with Tricare For Life can be claimed to Tricare as the secondary payor. Any co-pays or co-insurance not covered by Medicare and/or Tricare For Life will not be paid by Tricare For Life, but those benefits would not be covered at all without the Medicare Advantage Plan so you would likely have to pay the full cost of those anyway!


Consider a Medicare Advantage Plan without Prescription Drug Coverage.  Prescription drug coverage is a different animal altogether for most retired Veterans.  If you have Tricare For Life, then you likely have the Tricare prescription drug benefit.  Other retired veterans may also be getting prescription drugs using their Veterans Administration (VA) benefits.  If this is the case it may not be advisable to select a Medicare Advantage Plan with a Prescription Drug benefit because the drug benefit under the Medicare Advantage Plan will take over as the primary and those benefits and formularies/cost sharing may not be as favorable for the Veteran.

The bottom line on Medicare Advantage enrollment with Tricare For Life coverage may provide many “advantages” (pun intended) to the Veteran.  I recommend Veterans contact an Independent Agent who is knowledgable in matters pertaining to Medicare and Veterans.  Medicare Advantage Plans may be able to bring value and healthcare benefits well beyond what they have now!  An agent familiar with these plans will be able to make you aware of the pros and cons and allow you to make the decision that best meets your healthcare needs.

Marc Manor is a 30-year military veteran who is now dedicated to teaching his 
fellow Americans how to make the most of their Medicare and Supplemental Insurance benefits. As an independent agent, Marc has access to a wide variety of carriers with an abundance of resources to find tailored solutions. There is no charge for a consultation so call 904-222-0698 or email: marc@marcmanor.com.