Health Care for Retirees
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 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. You can also learn more about TRICARE at
http://www.tricare.mil/mybenefit/home/
overview/Plans/
LearnAboutPlansAndCosts/TRICAREForLife. Go to this website to find out more about
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 care—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. You can locate the BCAC for your state at
http://www.tricare.mil/bcacdcao/.
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 web site at
http://www.trdp.org/ 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:
- TRICARE does not cover all costs.
- TRICARE has a yearly deductible to be paid.
- TRICARE has a yearly cap on non-covered expenses; the cap is extremely high, and you are
responsible for the cost of non-covered items up to that amount.
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. For more information about TFL visit
http://www.tricare.mil/mybenefit/home/overview/Plans/
LearnAboutPlansAndCosts/TRICAREForLife or search on “TRICARE For Life; you may also call
Wisconsin Physicians Service-TFL at 1-866-773-0404 (1-866-773-0405 TTY/TDD for the hearing
impaired).
Survivors
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 regional contractor or visit
http://www.tricare.mil/.
Date Last Reviewed: November 6, 2009