Tricare and You – Retirement benefits

This blog is the most recent in a series helping members of the Coast Guard family understand how to use their TRICARE benefits. The blog series will continue every Monday, right here on Coast Guard All Hands.

Written by Cmdr. Paul Fawcett, chief of Medical Administration for Coast Guard’s Office of Health, Safety and Work-Life

Eligible Coast Guard retirees are entitled to TRICARE coverage. The type of coverage you receive does change as you age, and you have some choice of the type of coverage you receive. This article will help you better understand the type of coverage that you may receive.

TRICARE Prime

As a Coast Guard retiree, you are still eligible for TRICARE Prime, the coverage provided to all active duty members, however there are some changes.

You must reside in a Prime Service Area to be eligible for TRICARE Prime.

Although active duty members pay nothing out of pocket for their TRICARE Prime coverage, retirees pay $282.60 per year for individual coverage and $565.20 per year family coverage. Payments can be made annually, monthly, or quarterly. Eligible family members that may be covered include spouse and children who are registered in DEERs.

Retired Coast Guard Reserve members and their eligible family members may enroll in TRICARE Prime at age 60.

Retired beneficiaries may also pay network copayments ranging from $11-25 depending on the service.

In order for your TRICARE coverage to continue without interruption it’s important that you enroll within 30 days after retiring. You can do that by contacting your regional contractor via phone or on the web. When you enroll you can select your provider from the list provided and arrange to pay your enrollment fees. If you don’t take this action you may lose Prime coverage and revert to TRICARE Standard.

TRICARE Standard

TRICARE Standard is available to both active duty family members and retirees. This program provides you with more choices of providers, but at a higher cost. Eligible retirees enrolled in TRICARE Standard have an annual outpatient deductable cost of $150 per year for individuals E-5 and above, and $300 per family for E-5 and above. Lesser deductibles are assessed for E-4 and below. This deductable must be paid for TRICARE authorized services each year before TRICARE begins to pay medical fees.

Standard beneficiaries also pay cost shares for some services, ranging from 20-25 percent of allowable charges, depending on whether the provider is network or non-network.

There’s no annual enrollment fees assessed to TRICARE Standard beneficiaries and if you ensure you’re visit network providers, your costs will be lower.

Eligible retired reserve members and their eligible family members may enroll in TRICARE Standard at age 60.

TRICARE for Life

Eligible Coast Guard retirees transition to TRICARE for Life upon becoming eligible for Medicare part A and B, normally on turning 65 years of age. No enrollment is required. You must pay Medicare part B premiums in order for TRICARE for Life to be in effect. Your retired military ID card acts as your TRICARE ID card for TRICARE for Life. TRICARE enrollment fees are not assessed to TRICARE for Life Beneficiaries as long as Medicare fees are paid.

TRICARE for Life Beneficiaries may see any TRICARE authorized provider.

TRICARE Retired Reserve

Retired reserve members who have not yet tuned 60, and are therefore ineligible for TRICARE Prime, may enroll to TRICARE Retired Reserve. You must also not be enrolled in the federal Employees Health Benefits program to be eligible for TRICARE Reserve Select.

Costs for TRICARE Retired Reserve are $402.81 monthly for individuals and $1,013.36 per month for member and eligible family members. A two month premium is required upon enrollment. Additionally, there is a $150 per individual or $300 per family deductible, which must be paid for TRICARE authorized services before TRICARE begins to pay. Cost shares of 20-25 percent of allowable charges may also apply, depending on the service rendered.

Beneficiaries using TRICARE Retired Reserve may see any TRICARE authorized provider. Referrals for care are not required but certain types of care may require preauthorization.

For information on specific plans, to enroll in one of the TRICARE plans or ask questions about TRICARE programs contact:

TRICARE Regional contractors:

North-Health Net

1-877-TRICARE (1-877-874-2273)

https://www.hnfs.com/

 

South-Humana Military

1-877-249-9179

https://www.humanamilitary.com/

 

West-United Healthcare

1-877-988-WEST (1-877-988-9378)

https://www.uhcmilitarywest.com/

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