WEBVTT 00:00.033 --> 00:02.467 HOST: Good afternoon, and welcome to today's webinar titled, 00:02.467 --> 00:05.166 "Getting Started With Medicare and TRICARE." 00:07.200 --> 00:09.967 The appearance of hyperlinks does not constitute endorsement 00:09.967 --> 00:13.900 by the Department of Defense of this website or the information, 00:13.900 --> 00:17.233 products, or services contained therein. 00:17.233 --> 00:19.000 For other than authorized activities 00:19.000 --> 00:21.333 such as military exchanges and Morale, 00:21.333 --> 00:23.166 Welfare, and Recreation sites, 00:23.166 --> 00:27.266 the Defense Department does not exercise any editorial control 00:27.266 --> 00:31.500 over the information you may find at these locations. 00:31.500 --> 00:33.567 Such links are provided consistent with the 00:33.567 --> 00:37.333 stated purpose of this Defense Department-sponsored webinar. 00:39.266 --> 00:43.000 Are you or someone in your family turning 65 soon? 00:43.000 --> 00:45.033 To get TRICARE For Life coverage, 00:45.033 --> 00:49.033 you must have Medicare Part A and Part B. 00:49.033 --> 00:51.767 This webinar will give you a step-by-step overview of 00:51.767 --> 00:55.000 when and how to sign up for Medicare. 00:55.000 --> 00:57.567 You'll also learn how Medicare and TRICARE work together 00:57.567 --> 01:01.200 to minimize your out-of-pocket expenses. 01:01.200 --> 01:03.800 We're thrilled to have with us today Ms. Anne Breslin, 01:03.800 --> 01:06.133 TRICARE For Life program manager, 01:06.133 --> 01:09.767 TRICARE Health Plan, Defense Health Agency. 01:09.767 --> 01:12.266 Without further delay, I'll turn things over to Anne. 01:14.233 --> 01:16.233 ANNE BRESLIN: Thank you so much. 01:16.233 --> 01:17.367 Welcome, everyone. 01:17.367 --> 01:19.200 Thank you for joining us today. 01:19.200 --> 01:22.233 I believe you will find the next hour to be informative 01:22.233 --> 01:24.200 and helpful as you make plans to 01:24.200 --> 01:27.033 use the TRICARE For Life program. 01:27.033 --> 01:29.033 Let's get started. 01:29.033 --> 01:32.166 So we have a packed agenda for you today. 01:32.166 --> 01:37.033 I will be discussing TRICARE For Life, Medicare enrollment, 01:37.033 --> 01:41.967 the parts of Medicare, TRICARE Pharmacy Program, 01:41.967 --> 01:44.867 dental and vision coverage available to you, 01:44.867 --> 01:48.333 as well as how Medicare and TRICARE work together 01:48.333 --> 01:51.033 and how other insurance impacts 01:51.033 --> 01:54.734 that coordination of benefits, as well as resources. 01:54.734 --> 02:00.600 And hopefully we have time to answer many of your questions. 02:00.600 --> 02:03.033 So what is TRICARE For Life? 02:03.033 --> 02:06.367 TRICARE For Life is Medicare-wraparound coverage 02:06.367 --> 02:09.900 for military retirees, their family members 02:09.900 --> 02:12.333 who are entitled to Medicare Part A 02:12.333 --> 02:15.633 and Part B and also TRICARE. 02:15.633 --> 02:18.734 You'll receive TRICARE benefits under TRICARE For Life 02:18.734 --> 02:22.900 on the first day that both your Medicare Part A and Part B 02:22.900 --> 02:26.200 coverage are in effect— and of course, 02:26.200 --> 02:32.467 provided you also meet TRICARE eligibility requirements. 02:32.467 --> 02:36.066 So, you'll need to enroll in both Part A and Part B 02:36.066 --> 02:41.166 and show in DEERS as being eligible for TRICARE. 02:41.166 --> 02:45.600 TRICARE For Life coverage is available worldwide. 02:45.600 --> 02:49.767 So I'm frequently asked, when spouses are not of the same age, 02:49.767 --> 02:52.567 how does one of them turning 65 02:52.567 --> 02:55.400 and becoming entitled to Medicare impact the other? 02:55.400 --> 02:56.867 It doesn't. 02:56.867 --> 02:59.400 Medicare is an individual enrollment. 02:59.400 --> 03:03.166 Unless your birth dates are the exact same day, your coverage— 03:03.166 --> 03:04.367 or within the same month— 03:04.367 --> 03:08.667 your coverage isn't going to start at the same time. 03:08.667 --> 03:12.033 So, the younger spouse remains eligible for TRICARE Prime 03:12.033 --> 03:15.900 or Select, and the enrollment fee would be reduced to the 03:15.900 --> 03:18.533 individual enrollment fee. 03:18.533 --> 03:21.667 If you have children that are still eligible, 03:21.667 --> 03:23.800 then the family enrollment fee would remain. 03:26.734 --> 03:29.734 So how and when does one sign up for Medicare? 03:29.734 --> 03:33.166 If you're already receiving Social Security retirement 03:33.166 --> 03:36.333 or disability pay, you're automatically 03:36.333 --> 03:38.900 signed up for Medicare. 03:38.900 --> 03:43.100 You may have actually received it while under the age of 65, 03:43.100 --> 03:44.700 or already have Medicare. 03:44.700 --> 03:49.233 In that case, it just changes to eligibility based on age. 03:49.233 --> 03:52.700 So, you can sign up for Medicare on the Social Security website, 03:52.700 --> 03:55.300 which is ssa.gov. 03:55.300 --> 03:57.467 You can call the Social Security Administration, 03:57.467 --> 04:02.100 and the number is listed here: 800-772-1213. 04:02.100 --> 04:08.800 Or if you're hearing impaired, you can call 800-325-0778. 04:08.800 --> 04:11.700 You can also establish a meeting in person 04:11.700 --> 04:14.000 at your local Social Security office, 04:14.000 --> 04:19.166 and you can find those offices online at ssa.gov. 04:19.166 --> 04:23.133 Medicare has three different enrollment periods, 04:23.133 --> 04:25.800 and they're listed here. It's either Initial, 04:25.800 --> 04:27.900 General, or Special Enrollment Period, 04:27.900 --> 04:32.567 and we will cover the details of those. 04:32.567 --> 04:36.000 So everyone's individual enrollment period is based on 04:36.000 --> 04:42.367 their actual birthdate, as I alluded to previously. 04:42.367 --> 04:45.600 Your first chance to sign up for Medicare Part A and B 04:45.600 --> 04:48.300 based on age is during your Initial Enrollment Period, 04:48.300 --> 04:51.066 which is a seven-month period. 04:51.066 --> 04:54.900 If your birthday falls on the first day of the month, 04:54.900 --> 04:56.767 you should sign up for Medicare between two 04:56.767 --> 05:01.100 and four months before the month you turn 65, 05:01.100 --> 05:05.033 and that's in order to avoid a break in TRICARE coverage. 05:05.033 --> 05:09.500 You do have seven months to do so, but if you don't sign up 05:09.500 --> 05:14.333 before you turn 65 or within those two to four months before, 05:14.333 --> 05:16.800 you'll end up having a gap between 05:16.800 --> 05:19.200 when your Medicare Part B starts 05:19.200 --> 05:21.967 and when your Part A starts, which would result 05:21.967 --> 05:25.200 in a gap in your TRICARE coverage. 05:25.200 --> 05:28.400 If your birthday falls after the first day of the month, 05:28.400 --> 05:30.467 sign up for Medicare between one 05:30.467 --> 05:31.967 and three months before the month 05:31.967 --> 05:36.567 you turn 65 to avoid a break in coverage. 05:36.567 --> 05:38.433 Medicare coverage will start 05:38.433 --> 05:42.567 on the first day of the month you turn 65. 05:42.567 --> 05:47.000 And the goal is to sign up according to how I've described it here, 05:47.000 --> 05:50.233 so that your Part A and Part B begin on the same date. 05:52.900 --> 05:55.800 So, Medicare or Social Security do not send out notices 05:55.800 --> 06:00.834 to remind you when to sign up, but we do. 06:00.834 --> 06:02.834 But it's important that your contact information 06:02.834 --> 06:06.667 is up-to-date in DEERS, or that notice 06:06.667 --> 06:10.934 will go to a prior address that you have in DEERS. 06:10.934 --> 06:13.533 So please, first thing, is to check to make sure that 06:13.533 --> 06:17.934 your contact information is up to date. 06:17.934 --> 06:20.367 So here are some specific examples of what 06:20.367 --> 06:22.467 I was just discussing. 06:22.467 --> 06:26.367 Mr. Smith will turn age 65 on October 1st. 06:26.367 --> 06:30.567 He should sign up for Medicare between June 1st 06:30.567 --> 06:32.800 and actually, August 31st. 06:32.800 --> 06:35.367 You have until the end of the month 06:35.367 --> 06:38.367 to avoid a break in TRICARE coverage. 06:38.367 --> 06:43.967 Now, if he waits and signs up on August 31st, 06:43.967 --> 06:45.367 how many people would think 06:45.367 --> 06:51.266 that he's going to have his Medicare card on September 1st? 06:51.266 --> 06:52.900 I don't see any hands going up, 06:52.900 --> 06:55.967 and that's correct because he won't get it that quickly. 06:55.967 --> 06:59.900 So, while he can wait till August 31st, 06:59.900 --> 07:01.934 the sooner you sign up, the better, 07:01.934 --> 07:05.300 because it will just work out better for you. 07:05.300 --> 07:08.300 His Medicare coverage starts September 1st. 07:08.300 --> 07:12.233 That's because his birthday falls on the 1st. 07:12.233 --> 07:15.500 If your birthday falls on any other date—for example, 07:15.500 --> 07:19.266 Mrs. Green is going to turn 65 on October 2nd. 07:19.266 --> 07:21.934 She should sign up for Medicare between July 1st 07:21.934 --> 07:26.600 and September [30th] to avoid a break in TRICARE coverage. 07:26.600 --> 07:30.400 Her Medicare coverage will start October 1st. 07:30.400 --> 07:33.934 So, many people ask, "Does Medicare start on my birthday?" 07:33.934 --> 07:35.400 That's not correct. 07:35.400 --> 07:38.600 It either starts the 1st of the month in which you turn 65, 07:38.600 --> 07:41.100 or in the case when your birthday falls on the 1st, 07:41.100 --> 07:43.200 it's going to start at 1st of the month 07:43.200 --> 07:48.600 prior to the month in which you turn 65. 07:48.600 --> 07:51.000 The General Enrollment Period: 07:51.000 --> 07:53.333 This is an enrollment period for those folks 07:53.333 --> 07:57.900 who either do not sign up for Medicare Part B 07:57.900 --> 08:00.800 when they're first eligible 08:00.800 --> 08:03.533 or, for some reason, it gets terminated 08:03.533 --> 08:05.967 because they didn't pay their premiums. 08:05.967 --> 08:08.000 They have another opportunity to enroll, 08:08.000 --> 08:09.367 and that's during this time 08:09.367 --> 08:11.800 called the General Enrollment Period. 08:11.800 --> 08:17.233 It occurs every year between January 1st and March 31st. 08:17.233 --> 08:19.400 If you enroll during the General Enrollment Period, 08:19.400 --> 08:21.100 your coverage will start the month 08:21.100 --> 08:24.934 after you sign up. And your monthly Part B premiums 08:24.934 --> 08:29.967 can go up by 10% for every 12-month period 08:29.967 --> 08:33.567 you could have had Medicare Part B but didn't. 08:33.567 --> 08:36.467 So, it's not just a one-time fee. 08:36.467 --> 08:40.367 This is something that you would pay for the rest of your life. 08:41.734 --> 08:43.367 Generally, you won't have to pay a penalty 08:43.367 --> 08:45.633 if you qualify for a Special Enrollment Period, 08:45.633 --> 08:47.233 and I'll talk about that. 08:50.667 --> 08:56.734 So, a Special Enrollment Period is available for Medicare Part B. 08:56.734 --> 09:00.967 And the penalty for late enrollment is waived. 09:00.967 --> 09:02.734 If you are an active duty service member 09:02.734 --> 09:05.967 or a dependent of an active duty service member 09:05.967 --> 09:08.533 and you enrolled in the TRICARE plan, 09:08.533 --> 09:10.767 or if you're still working 09:10.767 --> 09:13.834 and have health coverage based on that job— 09:13.834 --> 09:17.266 so, it's employer-sponsored coverage while working. 09:17.266 --> 09:19.934 If you qualify for a Special Enrollment Period, 09:19.934 --> 09:21.667 you still must have Medicare Part A 09:21.667 --> 09:25.567 and B to have TRICARE For Life coverage. 09:25.567 --> 09:28.266 So while Medicare allows you to delay enrollment in Medicare 09:28.266 --> 09:34.166 Part B and rely on your employer-sponsored coverage, 09:34.166 --> 09:37.066 you would not have TRICARE as a secondary payer 09:37.066 --> 09:40.100 to your employer coverage. 09:40.100 --> 09:42.367 You can sign up for Medicare Part A and B 09:42.367 --> 09:44.700 at any time under this enrollment period. 09:44.700 --> 09:46.600 You can sign up any time while covered by the 09:46.600 --> 09:49.934 employer-sponsored plan 09:49.934 --> 09:52.500 and you're currently still working for the employer. 09:55.533 --> 09:58.500 As you plan for your retirement from that job, 09:58.500 --> 10:01.800 you should sign up for Medicare 10:01.800 --> 10:05.533 the month before you stop working 10:05.533 --> 10:08.900 or lose the employer coverage— whichever comes first. 10:08.900 --> 10:11.500 Or if you're an active duty sponsor, 10:11.500 --> 10:14.166 any family members who are entitled to Medicare, 10:14.166 --> 10:16.533 either based on age or disability, 10:16.533 --> 10:21.700 would sign up for Medicare a month before they retire 10:21.700 --> 10:24.967 so that you would avoid a break in your TRICARE coverage. 10:27.967 --> 10:31.133 So, I often get the question about 10:31.133 --> 10:34.266 if someone hasn't worked to meet the requirements 10:34.266 --> 10:36.367 for being eligible for Medicare, 10:36.367 --> 10:38.967 which is you have to have a job where you paid into 10:38.967 --> 10:42.934 the Social Security system for at least 10 years. 10:42.934 --> 10:47.333 Under that situation, if the individual is not married 10:47.333 --> 10:48.867 and never has been married, 10:48.867 --> 10:50.133 they would remain eligible 10:50.133 --> 10:53.000 for TRICARE without having Medicare. 10:53.000 --> 10:55.900 But they actually have to file for Medicare 10:55.900 --> 11:00.300 and get a Notice of Disapproved Claim. 11:00.300 --> 11:03.066 If you aren't eligible for Medicare Part A 11:03.066 --> 11:05.667 on your own work history 11:05.667 --> 11:08.934 but you have a current, former, or deceased spouse, 11:08.934 --> 11:13.400 you may sign up for Medicare on their record. 11:13.400 --> 11:19.166 If your spouse is 62 or older when you turn 65, 11:19.166 --> 11:22.000 you would sign up for Medicare on your own record, 11:22.000 --> 11:23.433 and if you're denied, 11:23.433 --> 11:27.467 then sign up for Medicare on your spouse's record. 11:27.467 --> 11:30.467 If your spouse is younger than age 62 11:30.467 --> 11:32.900 at the time you are turning 65, 11:32.900 --> 11:35.233 you sign up for Medicare on your own record, 11:35.233 --> 11:36.900 and if you're denied, 11:36.900 --> 11:40.233 you would get a Notice of Disapproved Claim 11:40.233 --> 11:42.734 or a Notice of Award. 11:42.734 --> 11:47.900 The award would be if you filed for Medicare Part B, 11:47.900 --> 11:49.433 and that's what I would recommend 11:49.433 --> 11:51.500 that you do if you anticipate being eligible 11:51.500 --> 11:55.367 on your spouse's record when he or she is 62. 11:55.367 --> 11:59.533 And the reason being is everyone can get Part B at age 65 11:59.533 --> 12:02.333 because it's premium-based. 12:02.333 --> 12:04.767 So, if your spouse is younger, 12:04.767 --> 12:07.066 you're not eligible for Medicare. 12:07.066 --> 12:09.600 Sign up, get the Notice of Disapproved Claim 12:09.600 --> 12:11.233 or Notice of Award, 12:11.233 --> 12:14.934 and that is the document that you would use to present 12:14.934 --> 12:17.533 to an ID card office, 12:17.533 --> 12:19.533 and that would allow you to continue 12:19.533 --> 12:24.300 your TRICARE coverage in the absence of Medicare Part A. 12:24.300 --> 12:28.066 But prior to your spouse's turning 62, 12:28.066 --> 12:30.166 you would then sign up for Medicare 12:30.166 --> 12:32.166 on your spouse's record, 12:32.166 --> 12:35.066 and then have A and B and TRICARE For Life. 12:37.533 --> 12:40.533 Medicare will send you a welcome package 12:40.533 --> 12:43.633 once you have been enrolled in Medicare. 12:43.633 --> 12:47.734 It will include your Medicare card and the Medicare handbook 12:47.734 --> 12:52.266 and a letter welcoming you to the Medicare program. 12:52.266 --> 12:55.567 As I mentioned, your TRICARE For Life will start the first day 12:55.567 --> 12:59.133 you have both Medicare Part A and Part B. 12:59.133 --> 13:02.000 We have a data match between the Centers for Medicare 13:02.000 --> 13:05.500 & Medicaid Services and the Defense Manpower Data Center, 13:05.500 --> 13:07.734 which manages DEERS— 13:07.734 --> 13:10.967 the Defense Enrollment Eligibility Reporting System. 13:10.967 --> 13:13.500 And so that's how the system is updated 13:13.500 --> 13:15.967 and tracks your Medicare entitlement. 13:15.967 --> 13:20.367 You will obviously need to pay for your Part B premiums. 13:20.367 --> 13:22.166 If you're not collecting Social Security, 13:22.166 --> 13:24.000 you'll be billed for those 13:24.000 --> 13:27.233 and you'll have to submit a check. 13:27.233 --> 13:30.667 Most likely, your ID card will be expiring, 13:30.667 --> 13:32.767 and you would need to take documentation 13:32.767 --> 13:36.500 to the ID card facility to have your ID card updated. 13:36.500 --> 13:38.900 I recommend calling them in advance to make sure 13:38.900 --> 13:44.367 you don't have to make a return trip to get some documents. 13:44.367 --> 13:48.467 With respect to the Part B premium, they are income based. 13:48.467 --> 13:52.967 If your income goes down, you can get your premium revised. 13:52.967 --> 13:54.967 There's information on the Medicare site 13:54.967 --> 13:59.467 about the breakouts of income 13:59.467 --> 14:02.433 and how that impacts your premium rates. 14:04.734 --> 14:06.500 Learn more about how to sign up for Medicare 14:06.500 --> 14:07.967 when your Medicare coverage 14:07.967 --> 14:14.133 starts at medicare.gov/basics. 14:14.133 --> 14:19.200 So, we do not issue a TRICARE For Life card 14:19.200 --> 14:20.767 to present at a doctor's office. 14:20.767 --> 14:23.533 What you use is your military ID card 14:23.533 --> 14:27.300 along with your Medicare card. 14:27.300 --> 14:30.500 Your providers will generally bill Medicare first, 14:30.500 --> 14:31.734 and then the claims 14:31.734 --> 14:34.467 will come over to TRICARE for payment 14:34.467 --> 14:36.934 towards your health care cost. 14:36.934 --> 14:38.600 If you lose your Medicare card, 14:38.600 --> 14:41.300 you can log on to your Medicare account, 14:41.300 --> 14:43.633 which you can establish on medicare.gov, 14:43.633 --> 14:46.233 and print an official copy of your card. 14:46.233 --> 14:51.800 You can also contact Medicare at 800-633-4227 14:51.800 --> 14:55.500 to order a replacement card. 14:55.500 --> 14:57.266 So, what are the parts of Medicare, 14:57.266 --> 14:59.300 and what do you need in 14:59.300 --> 15:02.033 order to have continued TRICARE coverage? 15:02.033 --> 15:04.867 First is Medicare Part A. 15:04.867 --> 15:09.000 "Original Medicare" refers to Medicare Part A and Part B. 15:09.000 --> 15:12.367 Part A is referred to as "hospital insurance" 15:12.367 --> 15:14.400 but covers more than care in a hospital. 15:14.400 --> 15:18.400 It can include care provided in a skilled nursing facility, 15:18.400 --> 15:23.300 hospice care, home health care, etc. 15:23.300 --> 15:26.133 You're eligible for premium-free Medicare Part A 15:26.133 --> 15:27.467 if you or your spouse worked 15:27.467 --> 15:29.767 and paid into the Social Security system 15:29.767 --> 15:32.166 for at least 10 years. 15:32.166 --> 15:33.700 There is something else called 15:33.700 --> 15:37.133 Medicare Supplemental Insurance, or Medigap. 15:37.133 --> 15:43.500 This is optional coverage. It is a premium-based coverage, and 15:43.500 --> 15:48.300 Medigap pays your out-of-pocket costs after Original Medicare. 15:48.300 --> 15:49.900 You can learn more about Medigap at 15:49.900 --> 15:58.500 medicare.gov/health-drug-plans/ medigap. 16:00.934 --> 16:03.767 Original Medicare Part B: 16:03.767 --> 16:06.600 Part B is referred to as medical insurance. 16:06.600 --> 16:08.567 It's funded through monthly premiums 16:08.567 --> 16:10.333 paid by the beneficiary, 16:10.333 --> 16:13.200 and it helps to cover costs for all of your, 16:13.200 --> 16:17.333 like, outpatient care with physicians, physical therapists, 16:17.333 --> 16:22.000 etc., including home health, durable medical equipment 16:22.000 --> 16:26.300 such as wheelchairs, walkers, hospital beds, 16:26.300 --> 16:29.200 and also preventive services like screenings, 16:29.200 --> 16:33.300 nearly wellness visits, and certain vaccines. 16:33.300 --> 16:34.800 As I previously mentioned, 16:34.800 --> 16:38.900 your Part B premium will be based on your income. 16:38.900 --> 16:41.200 The Social Security Administration would get 16:41.200 --> 16:46.467 information from the IRS so they are aware of what your income is, 16:46.467 --> 16:49.333 and as it changes you can request changes 16:49.333 --> 16:52.266 to your Part B premium. 16:52.266 --> 16:58.233 Learn more about Part B costs at medicare.gov. 16:58.233 --> 17:01.333 Medicare Part C and Part D: 17:01.333 --> 17:05.600 Medicare Part C refers to Medicare Advantage Plans. 17:05.600 --> 17:08.133 These are health plans offered by private companies 17:08.133 --> 17:10.233 that contract with Medicare. 17:10.233 --> 17:13.967 They provide Medicare Part A and B services, 17:13.967 --> 17:17.867 and the majority of them now provide Part D, 17:17.867 --> 17:20.367 which is prescription drug coverage 17:20.367 --> 17:22.467 from the Medicare program. 17:22.467 --> 17:24.433 They may offer some extra benefits 17:24.433 --> 17:26.734 that original Medicare doesn't cover, 17:26.734 --> 17:30.400 like vision, hearing, and dental services. 17:30.400 --> 17:35.567 But many of those services are limited to preventive services, 17:35.567 --> 17:37.900 so they're not comparable to FEDVIP, 17:37.900 --> 17:39.967 the Federal Employees Dental 17:39.967 --> 17:42.734 and Vision Insurance Program, 17:42.734 --> 17:45.533 which I will talk about later. 17:45.533 --> 17:49.567 Medicare Part D is prescription drug coverage. 17:49.567 --> 17:52.767 It also has monthly premium. 17:52.767 --> 17:55.333 Plans are run by private insurance companies 17:55.333 --> 17:58.300 that follow the rules set by Medicare. 17:58.300 --> 17:59.867 Medicare Advantage Plans typically 17:59.867 --> 18:02.066 include the Part D coverage, 18:02.066 --> 18:04.500 and you can learn more about these options 18:04.500 --> 18:14.600 at medicare.gov/drug-coverage-part-d, as in "dog." 18:14.600 --> 18:18.200 You don't need Medicare Part C or Part D to have 18:18.200 --> 18:19.900 TRICARE For Life. 18:19.900 --> 18:23.800 TRICARE For Life beneficiaries continue to be covered by 18:23.800 --> 18:26.467 the TRICARE prescription drug coverage, 18:26.467 --> 18:31.567 managed by our TRICARE Pharmacy Program and Express Scripts. 18:31.567 --> 18:34.133 With TRICARE For Life, you may be eligible to buy dental 18:34.133 --> 18:36.867 and vision coverage through the Federal Employees Dental 18:36.867 --> 18:38.433 and Vision Insurance Program. 18:41.300 --> 18:44.734 This is a simple comparison of Original Medicare with 18:44.734 --> 18:49.767 TRICARE For Life versus a Medicare Advantage Plan. 18:49.767 --> 18:52.066 Under Original Medicare and TRICARE For Life, 18:52.066 --> 18:55.300 you only pay your Part B premium. 18:55.300 --> 18:57.567 Under the Medicare Advantage Plan, 18:57.567 --> 18:59.400 you may have a monthly premium 18:59.400 --> 19:03.834 in addition to your Medicare Part B premium. 19:03.834 --> 19:06.633 Also under Original Medicare and TRICARE For Life, 19:06.633 --> 19:09.100 you can get healthcare from any Medicare participating 19:09.100 --> 19:11.967 or Medicare non-participating provider, 19:11.967 --> 19:13.467 and you don't need a referral 19:13.467 --> 19:16.333 or pre-authorization to see a specialist for care 19:16.333 --> 19:18.834 Medicare covers. 19:18.834 --> 19:22.200 Under Medicare Advantage, you must get all of your health care 19:22.200 --> 19:25.333 from your Medicare Advantage Plan providers— 19:25.333 --> 19:27.900 that if it has an HMO model. 19:27.900 --> 19:29.567 You're limited to their network, 19:29.567 --> 19:33.333 with the exception of emergency services. 19:33.333 --> 19:36.166 They also usually require referrals 19:36.166 --> 19:40.033 and prior authorizations to see a specialist. 19:40.033 --> 19:41.900 Again, under the Medicare— 19:41.900 --> 19:44.500 Original Medicare and TRICARE For Life— 19:44.500 --> 19:47.100 they work together to coordinate your benefits. 19:47.100 --> 19:50.033 When the care you receive is covered by Medicare and TRICARE, 19:50.033 --> 19:53.367 you pay nothing and you don't have to file any paperwork— 19:53.367 --> 19:56.934 no claims—provided, you follow the rules of obtaining 19:56.934 --> 19:58.600 care from Medicare participating 19:58.600 --> 20:01.000 and non-participating providers. 20:01.000 --> 20:02.900 Under Medicare Advantage Plan, 20:02.900 --> 20:06.433 you pay copayments for care at the time of service. 20:06.433 --> 20:08.300 And if you would like reimbursement 20:08.300 --> 20:10.100 from TRICARE For Life, 20:10.100 --> 20:13.367 you will need to file a claim with our contractor, 20:13.367 --> 20:16.700 Wisconsin Physicians Service, which is the TRICARE 20:16.700 --> 20:20.900 and Medicare-eligible program contractor, 20:20.900 --> 20:24.000 otherwise referred as the TFL contractor. 20:26.333 --> 20:27.900 So as I mentioned, 20:27.900 --> 20:32.000 you continue to be eligible for coverage for prescription drug 20:32.000 --> 20:35.367 coverage under the TRICARE Pharmacy Program. 20:35.367 --> 20:39.066 There are no monthly premiums for the TRICARE Pharmacy Program, 20:39.066 --> 20:42.367 and you can learn about the options and copayments at 20:42.367 --> 20:46.433 tricare.mil/pharmacy. 20:46.433 --> 20:49.433 And you can find how TRICARE covers specific drugs 20:49.433 --> 20:59.467 at esrx.com/tform. 20:59.467 --> 21:02.533 Before you enroll in a Medicare prescription drug plan, 21:02.533 --> 21:04.433 if that's something you want to do, 21:04.433 --> 21:06.200 compare the following with your 21:06.200 --> 21:09.000 TRICARE prescription drug coverage: 21:09.000 --> 21:13.500 monthly premiums, deductibles, copayments, and drug coverage. 21:17.133 --> 21:19.000 So as previously mentioned, 21:19.000 --> 21:23.400 you will likely qualify to purchase dental 21:23.400 --> 21:26.967 and/or vision coverage through the Federal Employees Dental 21:26.967 --> 21:31.867 and Vision Insurance Program, which is referred to as "FEDVIP." 21:31.867 --> 21:34.867 FEDVIP, offered by the U.S. Office of Personnel Management, 21:34.867 --> 21:36.967 is available to retired service members 21:36.967 --> 21:40.100 and their eligible family members. 21:40.100 --> 21:44.734 You can learn more about FEDVIP at benefeds.com. 21:44.734 --> 21:47.900 So, let me just say briefly that there are, 21:47.900 --> 21:51.200 I believe, like 10 different insurance companies 21:51.200 --> 21:54.567 under FEDVIP that provide dental coverage 21:54.567 --> 21:58.233 and with options for high or standard options. 21:58.233 --> 22:02.633 And vision coverage, I think is like five maybe. 22:02.633 --> 22:06.266 So, it's a little bit of work, but it's worth the effort 22:06.266 --> 22:08.867 to go to benefeds.com. 22:08.867 --> 22:11.700 Compare what's available to you 22:11.700 --> 22:15.367 and what best suits your needs. 22:15.367 --> 22:19.967 You can sign up 31 days before or 60 days after retirement 22:19.967 --> 22:25.734 from the military or during a FEDVIP qualifying life event. 22:25.734 --> 22:29.467 The FEDVIP qualifying life events don't line up exactly 22:29.467 --> 22:31.600 as those for TRICARE, 22:31.600 --> 22:33.467 so it's important to go to BENEFEDS 22:33.467 --> 22:36.233 to learn about what those are. 22:36.233 --> 22:41.900 In addition, you can sign up during the FEDVIP open season. 22:41.900 --> 22:43.767 This year's open season will be from 22:43.767 --> 22:49.400 November 13th through December 11th. 22:49.400 --> 22:53.667 So I mentioned previously that there are Medicare providers 22:53.667 --> 22:57.834 known as participating providers, and these providers accept the 22:57.834 --> 23:01.600 Medicare-allowed amount as payment in full. 23:01.600 --> 23:03.467 They will file claims with Medicare 23:03.467 --> 23:06.133 for the care you receive 23:06.133 --> 23:07.734 and you have no out-of-pocket costs 23:07.734 --> 23:09.033 when the care you receive is covered 23:09.033 --> 23:12.200 by both Medicare and TRICARE. 23:12.200 --> 23:15.266 Non-participating Medicare providers don't accept the 23:15.266 --> 23:18.066 Medicare-allowed amount as payment in full 23:18.066 --> 23:20.433 and they can be paid up to 15% 23:20.433 --> 23:22.734 above the Medicare-allowed amount. 23:22.734 --> 23:26.533 This doesn't impact you, as TRICARE will pick up 23:26.533 --> 23:28.600 that additional 15%, 23:28.600 --> 23:33.233 provided the care is TRICARE covered benefit. 23:33.233 --> 23:36.233 Now, there are some providers that don't want to participate 23:36.233 --> 23:39.467 in the Medicare program at all, 23:39.467 --> 23:42.834 so therefore, they cannot bill Medicare. 23:42.834 --> 23:45.834 And of course, Medicare is not going to pay them. 23:45.834 --> 23:49.667 If you see an opt-out provider, they will ask you 23:49.667 --> 23:51.967 to sign a private agreement 23:51.967 --> 23:56.133 with them about how much they will charge. 23:56.133 --> 24:01.000 TRICARE, under this scenario, will pay up to 20% of the TRICARE- 24:01.000 --> 24:04.500 allowable amount and you will remain responsible 24:04.500 --> 24:07.467 for the remainder of the billed charges. 24:07.467 --> 24:11.533 So, that is not the most cost-effective way of getting 24:11.533 --> 24:14.533 your health care, but if that is something you want, 24:14.533 --> 24:16.867 that is how it would play out. 24:18.867 --> 24:21.567 So how can you find a Medicare provider? 24:21.567 --> 24:24.100 Medicare has a search tool on their website at 24:24.100 --> 24:31.834 medicare.gov/care-compare. 24:31.834 --> 24:34.900 You can also call the Medicare customer service line at 24:34.900 --> 24:40.433 800-633-4227. 24:40.433 --> 24:43.533 You can search for doctors, hospitals, 24:43.533 --> 24:45.800 nursing homes, etc. 24:45.800 --> 24:48.800 You can type in your ZIP code and the type of provider 24:48.800 --> 24:50.900 you're looking for, whether it's an internist, 24:50.900 --> 24:54.533 a cardiologist, dermatologist, etc. 24:54.533 --> 24:58.700 And they will provide you the locations of their offices, 24:58.700 --> 25:01.033 whether or not they're accepting new patients, 25:01.033 --> 25:02.600 and the contact information. 25:02.600 --> 25:04.467 So, that's one way. 25:04.467 --> 25:06.500 You can also contact your current providers 25:06.500 --> 25:10.000 and see if they participate with Medicare. 25:10.000 --> 25:14.834 And talk to your friends to see who they see and who they like. 25:14.834 --> 25:18.133 Lots of ways to look for a doc. 25:18.133 --> 25:21.934 I do recommend that you start looking before you turn 65 25:21.934 --> 25:24.300 and before you become Medicare eligible 25:24.300 --> 25:26.767 because it's nice to have an established relationship 25:26.767 --> 25:31.033 with a provider before you actually need them. 25:31.033 --> 25:33.800 So, start now. 25:33.800 --> 25:36.233 If you choose to enroll in Medicare Advantage Plan, 25:36.233 --> 25:37.533 you'll need to contact 25:37.533 --> 25:43.734 that plan for their list of network providers. 25:43.734 --> 25:46.867 So if you're living overseas, you will need to pay for 25:46.867 --> 25:51.033 services up front and file claims for reimbursement. 25:51.033 --> 25:53.266 TRICARE is the primary payer unless 25:53.266 --> 25:55.700 you have other health insurance. 25:55.700 --> 25:59.133 Medicare does not provide coverage overseas. 25:59.133 --> 26:00.767 Some folks are used to getting care 26:00.767 --> 26:03.300 through the Veterans Affairs providers. 26:03.300 --> 26:06.867 Those providers are not permitted to bill Medicare, 26:06.867 --> 26:08.200 and Medicare can't pay 26:08.200 --> 26:10.200 for services received from VA facilities 26:10.200 --> 26:12.300 or their providers. 26:12.300 --> 26:15.633 If you see a VA provider for non-service-connected care, 26:15.633 --> 26:19.233 you will have significant out-of-pocket expenses. 26:19.233 --> 26:21.266 Similar to the opt-out providers 26:21.266 --> 26:23.734 that I previously talked about, 26:23.734 --> 26:27.734 when you see a VA provider for non-service-connected care, 26:27.734 --> 26:32.266 TRICARE will pay up to 20% of the TRICARE-allowable amount, 26:32.266 --> 26:33.567 and you may be responsible 26:33.567 --> 26:37.066 for the paying the remainder of the bill charges. 26:37.066 --> 26:41.367 So it's much more cost-effective to go outside the VA 26:41.367 --> 26:44.133 for non-service-connected care because you would have 26:44.133 --> 26:49.266 the advantage of both coverage from Medicare and TRICARE. 26:49.266 --> 26:51.567 You also have the option of receiving care 26:51.567 --> 26:57.033 at military hospital and clinics, if space is available. 26:57.033 --> 27:01.633 So here's a couple examples of what I previously described 27:01.633 --> 27:03.500 about provider types 27:03.500 --> 27:07.300 and how it impacts your out-of-pocket expenses. 27:07.300 --> 27:10.767 On the left, Mr. Smith gets care from a Medicare participating 27:10.767 --> 27:13.567 or non-participating provider. 27:13.567 --> 27:16.600 The provider bills $1,000. 27:16.600 --> 27:19.200 Medicare allowed $400. 27:19.200 --> 27:23.033 Medicare pays 80% of their allowable amount 27:23.033 --> 27:27.367 and TRICARE pays the remaining 20%, in this case $80, 27:27.367 --> 27:31.900 leaving Mr. Smith with no out-of-pocket expenses. 27:31.900 --> 27:35.266 On the right side, Mr. Smith gets non-service-connected 27:35.266 --> 27:38.533 care from a VA provider or hospital. 27:38.533 --> 27:41.800 The provider bills $1,000. 27:41.800 --> 27:45.533 TRICARE-allowable amount is $400. 27:45.533 --> 27:51.033 Medicare pays nothing, and TRICARE pays 20%—or $80. 27:51.033 --> 27:56.767 And Mr. Smith ends up with a bill of $320. 27:58.367 --> 28:01.900 How do you know what Medicare and TRICARE cover? 28:01.900 --> 28:04.233 Our policies are not identical, 28:04.233 --> 28:06.800 so you will find some differences. 28:06.800 --> 28:11.233 At some point, you may have some out-of-pocket expenses 28:11.233 --> 28:15.233 because the only time you have no out-of-pocket expenses is 28:15.233 --> 28:20.467 when the care you receive is covered by both plans. 28:20.467 --> 28:24.200 Medicare has limits on the amount of care it covers. 28:24.200 --> 28:26.333 In some cases, TRICARE For Life may cover these 28:26.333 --> 28:30.333 health care services after your Medicare benefits run out. 28:30.333 --> 28:35.567 One example there is skilled nursing facility care. 28:35.567 --> 28:38.066 Medicare's limit for skilled nursing facility 28:38.066 --> 28:41.000 care is 100 days. 28:41.000 --> 28:47.033 TRICARE does not have a limit. However, you have to still meet 28:47.033 --> 28:51.734 the requirements for skilled care, 28:51.734 --> 28:56.300 so that's important to understand. 28:56.300 --> 28:59.300 To see if Medicare covers a specific service or benefit, 28:59.300 --> 29:00.967 you can visit the Medicare website 29:00.967 --> 29:05.166 at medicare.gov/coverage or call 29:05.166 --> 29:13.033 Medicare at their customer service line: 800-633-4227. 29:13.033 --> 29:17.233 TRICARE covers proven medically necessary and appropriate care. 29:17.233 --> 29:19.867 To see if TRICARE For Life covers a specific service 29:19.867 --> 29:22.867 or benefit, you can visit the TRICARE website at 29:22.867 --> 29:28.633 tricare.mil/coveredservices 29:28.633 --> 29:31.066 or call the TRICARE For Life contractor, 29:31.066 --> 29:33.367 which is Wisconsin Physicians Service, at 29:33.367 --> 29:39.100 866-773-0404. 29:39.100 --> 29:41.200 For those of you in the East Region 29:41.200 --> 29:44.600 who are used to working with Wisconsin Physicians Service, 29:44.600 --> 29:47.567 please know that this is a separate contract 29:47.567 --> 29:50.600 and separate phone numbers, etc. 29:53.266 --> 29:58.300 So this chart is a brief description of who pays what. 29:58.300 --> 30:03.433 So as I mentioned, if care is covered by Medicare and TRICARE, 30:03.433 --> 30:06.567 you will have no out-of-pocket expenses because both Medicare 30:06.567 --> 30:09.734 and TRICARE work together to cover the cost. 30:09.734 --> 30:13.000 If the care you receive is covered by Medicare only, 30:13.000 --> 30:15.800 TRICARE will not pay anything, and you will be responsible 30:15.800 --> 30:19.767 for the Medicare deductible and cost-share. 30:19.767 --> 30:23.700 If the care you receive is covered only by TRICARE, 30:23.700 --> 30:26.100 Medicare pays nothing, and you will be responsible 30:26.100 --> 30:30.066 for the TRICARE deductible and cost-share. 30:30.066 --> 30:31.834 If you receive care that is covered by 30:31.834 --> 30:34.767 neither Medicare nor TRICARE, 30:34.767 --> 30:40.133 you will be responsible for 100% of the bill charges. 30:40.133 --> 30:42.000 If you have TRICARE For Life— 30:42.000 --> 30:44.667 which means you have Medicare also— 30:44.667 --> 30:48.033 and perhaps you have other health insurance, 30:48.033 --> 30:50.800 things can work a little differently. 30:50.800 --> 30:52.934 How Medicare coordinates with your other health insurance 30:52.934 --> 30:54.667 depends on whether that other health insurance 30:54.667 --> 30:57.367 is based on current employment. 30:57.367 --> 31:01.300 In either case, TRICARE For Life will pay last. 31:01.300 --> 31:03.300 If you have employer-sponsored insurance 31:03.300 --> 31:05.700 based on current employment, 31:05.700 --> 31:08.300 your other health insurance pays first, 31:08.300 --> 31:12.734 Medicare pays second, and TRICARE pays last. 31:12.734 --> 31:18.433 Your provider will file claims with Medicare, and Medicare 31:18.433 --> 31:23.433 will forward the claim to your other health insurance. 31:23.433 --> 31:25.467 But at that point, if your other health insurance 31:25.467 --> 31:27.667 does not forward the claim to TRICARE, 31:27.667 --> 31:29.266 you would have to file a paper claim 31:29.266 --> 31:31.567 after receiving your Medicare summary notice, 31:31.567 --> 31:34.033 which is basically an explanation of benefits, 31:34.033 --> 31:35.867 along with your explanation of benefits 31:35.867 --> 31:39.367 from your other health insurance. 31:39.367 --> 31:42.667 If you have OHI that isn't based on your 31:42.667 --> 31:45.266 or your family members' current employment, 31:45.266 --> 31:48.166 Medicare pays first, the OHI pays second, 31:48.166 --> 31:49.900 and TRICARE pays last. 31:52.300 --> 31:55.800 I'm sorry, when I previously spoke, when your OHI pays first, 31:55.800 --> 31:57.533 the Medicare pays second, 31:57.533 --> 31:59.667 Medicare coordinates with TRICARE. 31:59.667 --> 32:04.066 It's the second example there— when Medicare pays first 32:04.066 --> 32:07.300 and OHI pays second— TRICARE pays last. 32:07.300 --> 32:08.934 That's when you have to file a claim. 32:08.934 --> 32:10.934 Sorry about that. 32:10.934 --> 32:14.333 So before we move on to your questions, 32:14.333 --> 32:15.600 I want to take a moment 32:15.600 --> 32:18.433 or two to highlight some helpful resources. 32:18.433 --> 32:20.600 As a reminder, you can find these resources 32:20.600 --> 32:23.867 in the copy of the slide that you received. 32:23.867 --> 32:25.900 There are a few places on tricare.mil 32:25.900 --> 32:30.300 that are good starting points for learning about TRICAREF For Life: 32:30.300 --> 32:37.133 tricare.mil/tfl and tricare.mil/medicareeligible. 32:37.133 --> 32:42.166 I also recommend checking out tricare.mil/faqs. 32:42.166 --> 32:43.567 This is a great way to find answers 32:43.567 --> 32:46.533 to common TRICARE questions. 32:46.533 --> 32:50.266 You can also go to tricare.mil/publications 32:50.266 --> 32:52.667 to download the TRICARE For Life Handbook 32:52.667 --> 32:55.700 and two different TRICARE For Life brochures. 32:55.700 --> 32:59.467 One is about becoming Medicare-eligible at age 65 32:59.467 --> 33:04.567 and the other is about becoming Medicare-eligible before age 65. 33:04.567 --> 33:08.300 If you would like a hard copy of a TRICARE For Life Handbook, 33:08.300 --> 33:11.433 you can request one from the TRICARE For Life contractor, 33:11.433 --> 33:13.734 Wisconsin Physicians Service. 33:13.734 --> 33:17.934 Their contact info is on the next slide. 33:17.934 --> 33:20.600 I also want to encourage you to check out the Get to Know 33:20.600 --> 33:24.066 TRICARE podcast in the TRICARE Newsroom. 33:24.066 --> 33:25.900 There are six episodes about Medicare 33:25.900 --> 33:28.166 and TRICARE For Life topics. 33:28.166 --> 33:33.700 To find this podcast, go to newsroom.tricare.mil, 33:33.700 --> 33:37.100 hover over the Multimedia tab on the navigation bar, 33:37.100 --> 33:39.967 and click Podcast. 33:39.967 --> 33:43.266 You can play each podcast directly on the web page. 33:43.266 --> 33:45.800 You can also download a transcript if you prefer to read 33:45.800 --> 33:50.166 the information from that podcast. 33:50.166 --> 33:53.100 Here's the contact info for the two TRICARE For Life support 33:53.100 --> 33:55.367 contractors. And as a reminder, 33:55.367 --> 33:58.166 if you have questions about your TRICARE eligibility 33:58.166 --> 34:01.934 or DEERS, contact the Defense Manpower Data Center. 34:04.967 --> 34:08.166 If you have questions about signing up for Medicare itself, 34:08.166 --> 34:11.767 you should contact the Social Security Administration. 34:11.767 --> 34:14.734 For other Medicare questions, contact Medicare. 34:14.734 --> 34:16.000 And if you have questions 34:16.000 --> 34:19.000 about FEDVIP dental and vision plans 34:19.000 --> 34:21.900 and enrollment, you should reach out to BENEFEDS. 34:24.133 --> 34:26.567 Lastly, I want to remind you that there are many ways 34:26.567 --> 34:29.333 to stay up to date with TRICARE. 34:29.333 --> 34:32.500 You can go tricare.mil/subscriptions 34:32.500 --> 34:35.100 to subscribe to benefit update emails. 34:35.100 --> 34:38.300 You can also follow TRICARE on Facebook and Twitter. 34:42.233 --> 34:46.100 Now, let's answer some of your questions. 34:46.100 --> 34:48.900 HOST: Once on Medicare and TRICARE Prime, 34:48.900 --> 34:52.567 has enrolled to TRICARE For Life, 34:52.567 --> 34:56.033 will my prescriptions still be covered as they are now, 34:56.033 --> 34:59.767 or is this when Part D comes into play? 35:01.800 --> 35:05.166 BRESLIN: So, there's no requirement for Part D, 35:05.166 --> 35:06.734 and so your coverage would remain 35:06.734 --> 35:11.734 the same under the TRICARE prescription drug program. 35:11.734 --> 35:15.333 HOST: Do we still have to sign up for Part B 35:15.333 --> 35:20.333 if we still have employer health care through a spouse? 35:20.333 --> 35:22.000 BRESLIN: So I covered this during the presentation. 35:22.000 --> 35:25.533 I'll just briefly go over that Medicare allows you 35:25.533 --> 35:27.867 to delay your enrollment in Part B, 35:27.867 --> 35:30.066 but if you do that, you will rely on 35:30.066 --> 35:34.867 your employer coverage and will not have TRICARE coverage 35:34.867 --> 35:36.767 until you have Part B. 35:38.967 --> 35:40.333 HOST: I live in Portugal. 35:40.333 --> 35:43.867 Do I need TRICARE For Life or TRICARE Overseas 35:43.867 --> 35:46.433 or some other TRICARE program? 35:46.433 --> 35:48.800 I believe I have TRICARE For Life right now. 35:51.700 --> 35:54.800 BRESLIN: So if you're living in Portugal and you want TRICARE coverage 35:54.800 --> 35:56.533 and you're entitled to Medicare, 35:56.533 --> 35:59.467 you must have Medicare Part A and B, as in "boy," 35:59.467 --> 36:02.033 even though Medicare will not pay for services— 36:02.033 --> 36:04.967 health care services— you receive in Portugal 36:04.967 --> 36:08.867 or anywhere else overseas. 36:08.867 --> 36:13.200 HOST: If I switch to US Family Health Plan at PACMED, 36:13.200 --> 36:14.433 do I need to switch back 36:14.433 --> 36:17.967 to TRICARE before I enroll in Medicare? 36:19.500 --> 36:22.133 BRESLIN: So if you weren't enrolled in US Family Health Plan 36:22.133 --> 36:26.133 before, I believe, October 1st of 2012, 36:26.133 --> 36:27.533 I think is the right date. 36:27.533 --> 36:30.934 If you weren't enrolled from that point 36:30.934 --> 36:34.767 and continuously until the point in which you become 65, 36:34.767 --> 36:36.800 you will be disenrolled. 36:36.800 --> 36:40.033 So if you enroll now and turn 65 next year, 36:40.033 --> 36:42.200 let's say, you will be disenrolled 36:42.200 --> 36:44.467 and you'll have to have Medicare Part A and B. 36:46.867 --> 36:50.767 HOST: OK. Is the enrollment fee change automatic 36:50.767 --> 36:54.967 or do we need to inform TRICARE of the change? 36:54.967 --> 36:58.734 BRESLIN: It should be automatic, as they will disenroll 36:58.734 --> 37:04.767 the individual turning 65 and adjust it at that point. 37:04.767 --> 37:06.300 HOST: Can we access pharmacy benefits 37:06.300 --> 37:09.433 if we don't have TRICARE For Life, 37:09.433 --> 37:11.633 if we do not have Medicare Part B 37:11.633 --> 37:13.800 because of having employer health? 37:15.834 --> 37:17.867 BRESLIN: No. In order to remain eligible for 37:17.867 --> 37:20.767 the TRICARE prescription drug benefit, 37:20.767 --> 37:23.000 you would have to be eligible for TRICARE For Life 37:23.000 --> 37:26.166 or another TRICARE program. 37:28.066 --> 37:33.867 HOST: If we're still working at 65, can you stay with TRICARE? 37:33.867 --> 37:39.967 BRESLIN: Only if you enroll in Medicare Part A and B, as in "boy." 37:41.600 --> 37:45.000 HOST: What if I'm sick— receiving Social Security 37:45.000 --> 37:48.000 and still have coverage under Blue Cross Blue Shield— 37:48.000 --> 37:49.166 and do not want to be 37:49.166 --> 37:51.734 enrolled in Medicare or TRICARE For Life? 37:51.734 --> 37:53.700 Will I be signed up automatically? 37:53.700 --> 37:56.367 How do I stop it? 37:56.367 --> 37:58.700 BRESLIN: So if you're already receiving Social Security 37:58.700 --> 38:01.166 before the age of 65, 38:01.166 --> 38:03.867 you are automatically enrolled in Medicare Part A 38:03.867 --> 38:06.734 and Part B, as in "boy." 38:06.734 --> 38:10.033 If they're working and have employer coverage, 38:10.033 --> 38:13.033 they can ask not to have the Part B 38:13.033 --> 38:14.500 because they're eligible for that 38:14.500 --> 38:17.333 Special Enrollment Period that I referred to earlier. 38:17.333 --> 38:20.367 However, they would not have TRICARE. 38:20.367 --> 38:22.834 HOST: If I have private insurance through my work 38:22.834 --> 38:24.767 and don't sign up for Part B 38:24.767 --> 38:26.900 until later with a special enrollment, 38:26.900 --> 38:29.734 is my eligibility for TRICARE For Life restored 38:29.734 --> 38:33.233 when I sign up for Part B? 38:33.233 --> 38:35.934 BRESLIN: Yes, you will have Tricare For Life the first date 38:35.934 --> 38:41.800 that you have Medicare Part A and Part B, as in "boy." 38:41.800 --> 38:44.367 HOST: Is the premium based on the individual 38:44.367 --> 38:47.533 or the household income? 38:47.533 --> 38:53.333 BRESLIN: If there are two wage earners, it's based on the couple. 38:53.333 --> 38:59.000 If it's a single wage earner, it's based on the single person. 38:59.000 --> 39:02.300 HOST: Can we use an allotment from retirement pay 39:02.300 --> 39:05.934 to pay for Part B? 39:05.934 --> 39:08.867 BRESLIN: No, it's either taken from your Social Security pay. 39:08.867 --> 39:10.133 If you're not receiving that, 39:10.133 --> 39:13.066 you receive a bill every quarter. 39:13.066 --> 39:17.734 HOST: Can I use military-based pharmacy? 39:17.734 --> 39:19.100 Can I still— 39:19.100 --> 39:20.367 BRESLIN: Yes, that's right. 39:20.367 --> 39:24.533 Your pharmacy option do not change. It's the same program. 39:26.033 --> 39:29.033 HOST: OK. And I know we had a similar question to this one. 39:29.033 --> 39:31.800 If you're still employed and have medical insurance, 39:31.800 --> 39:34.867 do you still go to Social Security Administration 39:34.867 --> 39:37.033 to sign up for Part A 39:37.033 --> 39:40.734 and Part B or just Part A? 39:40.734 --> 39:42.600 BRESLIN: So, if you're choosing to rely on your 39:42.600 --> 39:44.000 employer-sponsored coverage, 39:44.000 --> 39:46.767 you would sign up for just Part A because 39:46.767 --> 39:51.066 you can delay Part B without penalty. 39:51.066 --> 39:54.600 However, you won't have TRICARE coverage. 39:54.600 --> 39:57.200 HOST: OK. Can someone who has Medicare 39:57.200 --> 40:04.900 but is on USFHP use the TRICARE pharmacy? 40:04.900 --> 40:06.367 BRESLIN: No. They cannot. 40:06.367 --> 40:09.834 US Family Health program has their own pharmacy program. 40:09.834 --> 40:12.867 You have to follow their guidelines. 40:12.867 --> 40:16.133 HOST: How can I continue to see my assigned PCM 40:16.133 --> 40:18.667 for my time on TRICARE Prime? 40:20.400 --> 40:23.567 BRESLIN: So, if that is a provider within 40:23.567 --> 40:26.000 a military treatment facility, 40:26.000 --> 40:28.800 there's a program called TRICARE Plus. 40:28.800 --> 40:31.967 It's offered in some but not all military facilities, 40:31.967 --> 40:33.967 and it's based on their capability 40:33.967 --> 40:37.667 and capacity to keep you, 40:37.667 --> 40:41.667 so you would have to inquire at that facility. 40:41.667 --> 40:45.900 If the provider is outside, you would simply have to ask them 40:45.900 --> 40:48.367 if they participate in Medicare 40:48.367 --> 40:51.867 and if they would continue to be your provider. 40:53.667 --> 40:55.200 HOST: Do my current prescriptions 40:55.200 --> 41:01.734 and referrals under TRICARE expire when I turned 65? 41:01.734 --> 41:03.533 BRESLIN: No. So, as I mentioned, 41:03.533 --> 41:06.033 the TRICARE Pharmacy Program is the same 41:06.033 --> 41:09.800 no matter what TRICARE health plan you're enrolled in. 41:09.800 --> 41:12.266 So, becoming eligible for TRICARE For Life 41:12.266 --> 41:16.800 does not change your pharmacy benefits. 41:16.800 --> 41:21.700 HOST: If you don't live overseas but travel overseas for vacation, 41:21.700 --> 41:25.400 are you still covered by TRICARE For Life? 41:25.400 --> 41:26.767 BRESLIN: You are. 41:26.767 --> 41:29.967 So, you wouldn't have Medicare as a primary insurer. 41:29.967 --> 41:33.266 So, TRICARE would become your primary payer, 41:33.266 --> 41:35.700 and you'd be responsible for the TRICARE deductible 41:35.700 --> 41:36.767 and cost-share 41:36.767 --> 41:39.133 associated with the care you receive. 41:39.133 --> 41:41.300 Generally, when you receive care overseas, 41:41.300 --> 41:43.467 you have to pay up front for that care 41:43.467 --> 41:45.400 and then file a claim. 41:45.400 --> 41:48.533 You would file that with the TRICARE Overseas Program 41:48.533 --> 41:53.066 contractor, which is International SOS, 41:53.066 --> 41:55.400 and I believe you have up to three years 41:55.400 --> 41:58.400 to submit those— versus in United States, 41:58.400 --> 42:02.333 they have to be submitted within one year. 42:02.333 --> 42:05.266 HOST: For TRICARE for Life coverage, do we need to ensure the 42:05.266 --> 42:08.934 provider accepts Medicare and TRICARE For Life, 42:08.934 --> 42:13.000 or is TRICARE For Life assumed? 42:13.000 --> 42:15.000 BRESLIN: If the care you are receiving is provided by Medicare, 42:15.000 --> 42:16.367 the most important thing 42:16.367 --> 42:19.066 is that you find a provider that accepts Medicare 42:19.066 --> 42:21.000 either as a Medicare participating 42:21.000 --> 42:25.333 or Medicare non-participating provider. 42:25.333 --> 42:28.266 HOST: So once I'm eligible for Medicare, 42:28.266 --> 42:31.667 my wife who is younger stays on TRICARE Select— 42:31.667 --> 42:34.433 as I'm a retiree— and the TRICARE premium 42:34.433 --> 42:38.433 goes to single instead of family? 42:38.433 --> 42:41.700 BRESLIN: That's correct. 42:41.700 --> 42:44.834 HOST: Are pharmacies at military treatment facilities— 42:44.834 --> 42:50.100 MTFs—part of the TRICARE Pharmacy Program? 42:50.100 --> 42:52.934 BRESLIN: Yes, they are. 42:52.934 --> 42:55.500 HOST: Under TRICARE prescription program, 42:55.500 --> 42:56.867 do we need to do anything 42:56.867 --> 43:02.233 to transition from Walgreens to the program? 43:02.233 --> 43:06.333 BRESLIN: So, I believe Walgreens is one of the network providers. 43:06.333 --> 43:08.734 You can verify whether a pharmacy 43:08.734 --> 43:11.600 is part of the TRICARE network of providers 43:11.600 --> 43:18.300 on the tricare.mil/pharmacy web page. 43:18.300 --> 43:20.467 So there would be no transition if that pharmacy 43:20.467 --> 43:23.333 is part of the network. 43:23.333 --> 43:27.934 HOST: How do you cancel TRICARE Select? 43:27.934 --> 43:30.533 BRESLIN: I'm not an expert on enrollment, 43:30.533 --> 43:34.700 but we have annual enrollment periods for TRICARE Select. 43:34.700 --> 43:36.567 But if you're turning 65, 43:36.567 --> 43:38.000 then you become entitled to Medicare, 43:38.000 --> 43:43.066 You will be automatically disenrolled from Select. 43:43.066 --> 43:45.467 And then your TRICARE For Life starts the date 43:45.467 --> 43:47.033 you have A and B. 43:47.033 --> 43:50.100 So, if you sign up late for Part B, 43:50.100 --> 43:51.500 then you have a period of time 43:51.500 --> 43:53.767 where you have Part A only. 43:53.767 --> 43:57.900 You will already have been disenrolled from TRICARE Select, 43:57.900 --> 44:01.734 and you will have nothing until your Part B coverage starts. 44:01.734 --> 44:03.000 Refer back to my slides. 44:03.000 --> 44:06.333 Anytime you have Part A only, there's no coverage. 44:06.333 --> 44:08.834 The month that you turn 65— you know, 44:08.834 --> 44:12.100 let's say your birthday is any day other than the 1st— 44:12.100 --> 44:14.266 your Medicare coverage should be effective 44:14.266 --> 44:17.700 the 1st of the month in which you turn 65. 44:17.700 --> 44:24.000 So, you will be disenrolled from Select or Prime at midnight 44:24.000 --> 44:28.166 before the 1st of the month in which you turn 65. 44:28.166 --> 44:31.467 So, that's when you want to make sure you have your A and B. 44:31.467 --> 44:34.767 LENNYA BONIVENTO: Hi, Anne. This is Lennya Bonivento— 44:34.767 --> 44:36.767 sorry—from DHA communications. 44:36.767 --> 44:38.767 Just wanted to add on to the information 44:38.767 --> 44:40.900 about TRICARE Select. 44:40.900 --> 44:45.266 You can disenroll from TRICARE Select at any time by contacting 44:45.266 --> 44:48.834 the contractor or going through BWE. 44:48.834 --> 44:50.700 However, if you do disenroll, 44:50.700 --> 44:54.000 you cannot enroll into any other plan until, 44:54.000 --> 44:56.700 like Anne mentioned, during open season. 44:56.700 --> 44:58.533 And this is just about disenrolling 44:58.533 --> 44:59.700 from TRICARE Select. 44:59.700 --> 45:02.333 It has nothing to do with the information that Anne 45:02.333 --> 45:05.233 gave about the TRICARE For Life transition. 45:05.233 --> 45:07.266 So, just to answer the question about disenrolling 45:07.266 --> 45:08.600 from TRICARE Select, 45:08.600 --> 45:11.467 you can do so by contacting your contractor 45:11.467 --> 45:14.367 or going to the BWE website. 45:14.367 --> 45:16.767 But you would not be able to switch into another plan 45:16.767 --> 45:20.567 unless you have a Qualifying Life Event. 45:20.567 --> 45:24.133 HOST: I retired from the Navy Reserve after 27 years. 45:24.133 --> 45:27.734 I'm under my husband's insurance at present. 45:27.734 --> 45:30.200 Will my TRICARE For Life be different from anyone 45:30.200 --> 45:33.533 who was active duty? 45:35.066 --> 45:39.867 BRESLIN: You're eligible on your own or on your sponsor's record. 45:39.867 --> 45:43.333 Anyone else have anything else to add to that? 45:43.333 --> 45:44.767 CALVIN KELLER: Yeah. Hi, Anne. This is Calvin. 45:44.767 --> 45:48.233 Keller from DHA Communications as well. 45:48.233 --> 45:52.533 When you say you retired from the Reserves after 27 years, 45:52.533 --> 45:57.233 I am hoping that you mean that you have reached the age of 65. 45:57.233 --> 46:00.767 Because if not, you don't become eligible for full TRICARE benefits 46:00.767 --> 46:02.633 until you are 60. 46:02.633 --> 46:06.166 And then you're eligible for Prime, if available in your area, 46:06.166 --> 46:08.900 or Select. But yes, when you become 65 46:08.900 --> 46:12.100 and you're ready to become TRICARE For Life, 46:12.100 --> 46:15.800 as Anne stated, you must have Medicare Part A and B 46:15.800 --> 46:20.367 to get TRICARE. 46:20.367 --> 46:25.400 HOST: Then last question, Anne: I already have Part A and Part B, 46:25.400 --> 46:28.266 Birthday is June 5. Do I need to go to DEERS 46:28.266 --> 46:31.300 and update my status? 46:31.300 --> 46:34.133 BRESLIN: So DEERS, if you already have youre A and B, 46:34.133 --> 46:36.734 they probably know that. 46:36.734 --> 46:40.000 It would have come across on data match. 46:40.000 --> 46:42.767 But what you need to do is look at your military ID card 46:42.767 --> 46:45.233 and see when it says "expiring" 46:45.233 --> 46:47.700 and contact your local ID card facility 46:47.700 --> 46:51.967 and get a new updated card. 46:51.967 --> 46:54.266 HOST: And Anne, do you have any final or closing thoughts 46:54.266 --> 46:57.467 that you'd like to share with the audience? 46:57.467 --> 47:02.333 BRESLIN: I am thankful that you all took the time to listen to 47:02.333 --> 47:04.934 the information I had to share with you today. 47:04.934 --> 47:08.867 Do use the multiple references that are included 47:08.867 --> 47:11.300 because everything that I've shared 47:11.300 --> 47:16.100 with you should be in print and very clear. 47:16.100 --> 47:18.734 If something I said didn't make sense to you, 47:18.734 --> 47:23.166 maybe if you read it directly, you'll find it more helpful. 47:23.166 --> 47:25.800 If we didn't answer your questions, 47:25.800 --> 47:28.934 I believe there may be an opportunity to submit more, 47:28.934 --> 47:33.033 and we're happy to address them as time permits. 47:33.033 --> 47:35.533 Thank you very much. 47:35.533 --> 47:37.700 HOST: I just want to thank Anne and her team for sharing 47:37.700 --> 47:41.000 your invaluable experience and expertise today. 47:41.000 --> 47:42.900 I'd also like to thank you, all of our attendees, 47:42.900 --> 47:45.533 for participating in today's webinar. 47:45.533 --> 47:47.133 If we didn't answer your question today, 47:47.133 --> 47:49.066 please refer to the contact information 47:49.066 --> 47:51.367 in your copy of the webinar slide deck. 47:51.367 --> 47:54.600 Also, you may find the answers to questions about TRICARE 47:54.600 --> 47:57.967 on the TRICARE website at tricare.mil. 47:57.967 --> 48:00.200 This concludes today's webinar on getting started 48:00.200 --> 48:02.433 with Medicare and TRICARE. 48:02.433 --> 48:03.333 Thank you.