- The Washington Times - Tuesday, May 21, 2013

Dear Sgt. Shaft:

Thank you for a most informative column. However, the more I read and the more I ask the question, I become more confused. So does my wife, in the matter of our health insurance cost after the age of 65.

My wife — who is currently eligible for benefits under TRICARE For Life (TCL) as a second payee after her employer-sponsored health insurance plan has paid and she has not reached the age of 65 — will turn 65 in June 2013 and therefore must enroll in Medicare Part A and Part B to continue with TCL benefits.

(TRICARE is the health care program serving uniformed service members, retirees and their families worldwide.)

She must continue to work in order to receive full Social Security benefits upon retirement when she reaches age 66.

She has received direction that to remain TCL eligible, she must enroll in Medicare Part B. But she continues to receive employer-sponsored health insurance plan coverage until her employment terminates.

Why then would she need to enroll in Medicare Part B with its cost to continue to receive TCL, while still enrolled in an employer-sponsored health insurance plan just so that a TCL supplemental plan would kick in?

Our income decreases and it appears that our cost increases. How do we avoid paying the additional Part B cost and still receive the benefits of TCL coverage after the employer-sponsored health insurance plan pays?

It seems that the employer-sponsored health insurance plan must pay before TCL under any condition, but that Medicare Part B must also be in place for the TCL to pay a remaining amount after she reaches age 65. However, she must remain in the employer-sponsored health insurance plan until reaching age 66 as a condition of her employment.

Why then should she need to enroll in Part B at age 65?

Thomas S.
USAF Master Sergeant (retired)

Dear Tom:

I asked Jim Schwartz from TRICARE for Life to contact you to contact you. Here is how he responded to my inquiry:

Here is what I know, Medicare allows individuals covered by group health plan coverage to delay their Part B enrollment and sign up during a special enrollment period. However, to remain TRICARE-eligible, all TRICARE beneficiaries (except for active duty family members) must purchase Part B, when first entitled to Medicare. TRICARE will not act as a secondary payer to your group health plan coverage. You will not be TRICARE-eligible until you purchase Part B.

If you wait to enroll in Part B because you or your spouse were still working and had group health plan coverage, you may sign up during a special enrollment period. If this applies to you, you can sign up for Part B:

Option 1: Anytime while you are still covered by the group health plan, through your or your spouse’s current employment status.

Option 2: During the eight months following the month the group health plan coverage ends, or the employment ends (whichever is first)

Enrollment in an employer-sponsored health care plan does not replace the need to enroll in Medicare Part B to retain TRICARE coverage.

Shaft notes

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