August 8

Can Veterans Benefit From Having A Medicare Advantage Plan?

Do you have clients that have TRICARE for Life and who are also interested in a Medicare Advantage Plan with or without a Part D Plan? Well those clients can enroll in a Medicare Advantage Plan including a Part D even if they have TRICARE for Life.

Veterans Who Enroll In A Zero Premium Plan Will Extend Their Network

This allows the beneficiary to have choices and even get more services offered under the Medicare Advantage Plan.

Medicare Supplement Plans don’t typically pay off a denied Medicare EOB. TRICARE for Life is different. It will pay off of a denied Medicare Advantage claim if it is a Medicare covered benefit.

So if you have a client that is going to a provider that is not in their MAPD network, however it is a covered benefit, TRICARE for Life will continue to pick up that claim just as they would on Original Medicare.

When someone enrolls in a Medicare Advantage Plan with TRICARE for Life, they do not lose any of the benefits that they currently have with TRICARE. They still get all of the services they're entitled to, plus they get the extra value added services from that Medicare Advantage Plan.

Veterans Benefits & Medicare Advantage

As I’ve been speaking with different agents and agencies, there are still many who are not aware that TRICARE For Life enrollees are eligible to enroll into MA or MAPD plans. I wanted to ensure that every agent is aware of what is available for our TRICARE For Life enrollees so I thought I would share a document that was provided to me along with additional information.

TRICARE For Life enrollees can enroll into MA or MAPD plans without interrupting their current coverage.

What is the benefit to them?

  • Silver Sneakers
  • Vision
  • Dental
  • Hearing
  • OTC Catalog

For areas where there is a $0 premium option, you can choose either an MA-Only option or the MAPD option, whichever is best suited for these clients. If they enroll into the MA-Only option, there is no extra cost to the enrollee and they do not need the Rx benefit since it’s available through TRICARE For Life.

In addition, TRICARE For Life will pay from a denied Medicare Advantage EOB in certain circumstances. The service must be provided by a Medicare approved provider AND it must be a TRICARE For Life covered service. So, if the enrollee sees a non-contracted provider with their Medicare Advantage carrier, but the provider is a Medicare approved provider AND the service is a TRICARE For Life covered service, the claim will be paid.

See this document; specifically Page 4 for a breakdown. 

With the large VA population we have in our areas, agents should be offering the $0 premium plan to those who utilize the VA as well. Medicare Advantage Plans do not coordinate benefits with the VA.

Why is this a benefit for them?

Veterans can utilize the VA for all services done within the VA. If they need or want to go outside of the VA for any services, they can use their Medicare Advantage plan to utilize any of those contracted providers for a small copayment rather than depending on Original Medicare. They can also receive the Silver Sneakers membership, vision, dental, hearing, OTC catalog, etc. as value added services.


You may also like

ACA Training – How the Affordable Care Act Works, Products and Support from TMG

ACA Training – How the Affordable Care Act Works, Products and Support from TMG
  • {"email":"Email address invalid","url":"Website address invalid","required":"Required field missing"}