Tricare And Medicare

[akwidow]

Dad has tricare, being a retired National Guardsman. He also has Medicare. Can a person in this position use the supplimental coverage (medicare part a and :D to pay co-pays that the VA levys on the veteran?

Edited February 7, 2010 by akwidow

[LarryJ]

TRICARE for Life (TFL)

While Medicare is your primary insurance, TRICARE acts as your secondary payer minimizing your out-of-pocket expenses. TRICARE benefits include covering Medicare’s coinsurance and deductible.

Note: If you’re under age 65, have Medicare Part B, and live in a TRICARE Prime service area, you have the option to enroll in TRICARE Prime; TRICARE waives your TRICARE Prime enrollment fee.

How TFL Works With Medicare

If you use a Medicare provider, he or she will file your claims with Medicare. Medicare pays its portion and electronically forwards the claim to the TFL claims processor. TFL pays the provider directly for TRICARE-covered services.

For Medicare and TRICARE-covered services, Medicare pays first and TFL pays your remaining coinsurance for TRICARE-covered services.For services covered by TRICARE but not by Medicare, such as care received overseas, TFL pays first and Medicare pays nothing. You must pay the TRICARE fiscal year deductible and cost shares.

For services covered by Medicare but not by TRICARE, such as chiropractic services, Medicare pays first and TFL pays nothing. You must pay the Medicare deductible and coinsurance.

For services not covered by Medicare or TRICARE, such as cosmetic surgery, Medicare and TRICARE pay nothing and you must pay the entire bill.

Now, are you saying that your dad has Tricare and Medicare A&B, AND the VA. And, if he is using the VA medical system, is he, in fact, a "disabled veteran" and, if so, by what percentage is he disabled? If he IS a disabled vet then it will depend upon his percentage of disability as to whether he has to pay anything, or not.

But, to answer your question as best I can, Medicare is always the PRIMARY payor, then TRICARE. VA will not bill Medicare OR Tricare so, if there is a deductible co-pay, due to his not having the necessary 50% disability that allows him medical care without co-payments, at the VA, then he will wind up having to pay the co-payments.

It is much better that he receive his care away from the VA, thereby he will be covered by Medicare AND TRICARE, which will pick up the portion that Medicare did not pay.

...................or, at least, that's the way that I understand it, I think, maybe????? heck, I've sat here and wound up confusing MYSELF!

Edited February 7, 2010 by LarryJ

[akwidow]

Well there, you see, I thought Tricare WAS WHAT they got at the VA! So now I am going to have to ask more questions.

To the best of my knowledge Dad (87) has no service connected maladies...but it has been just recently that they have started charging him for medical care. I know because my mother fell behind in paying the bills, and I saw a charge for an office visit.

I'll be calling VAMC Monday to ask all the important questions.

Thanks, Larry