See how Medicare and TRICARE For Life coordinate.

Start with eligibility and effective dates

TRICARE For Life is Medicare-wraparound coverage for people who are TRICARE-eligible and have Medicare Part A and Part B, regardless of age. It is not a benefit every veteran automatically receives.

Check each household member separately. Confirm Medicare effective dates and current military-benefit eligibility rather than assuming that one person's coverage extends to everyone in the family.

Know which program covers the service

TRICARE describes Medicare as the primary coverage and TFL as secondary for TRICARE-covered services when a beneficiary chooses Medicare Advantage. A service's coverage under Medicare, TRICARE, or both can affect what remains payable.

Before a scheduled service, identify the provider, the Medicare arrangement, and the payer sequence. Overseas care is another reason to obtain the program's specific guidance instead of reusing a domestic example.

Look at the claims work—not only added benefits

TRICARE says you do not lose TFL simply by enrolling in Medicare Advantage. It also warns that Medicare Advantage claims do not use the usual crossover process and that you will need to file claims for reimbursement of TRICARE-covered services.

Ask the TFL contractor what documentation is required, who submits it, and how the proposed plan affects the providers you use. A smooth process with today's coverage is a real consideration in a comparison.

Treat prescription coverage as its own decision

TFL includes access to the TRICARE Pharmacy Program; Medicare Part D is not required just to have prescription coverage through TFL. TRICARE also notes that Part D can be worth examining in some circumstances.

Compare the actual medications, pharmacy locations, costs, and coordination before adding a drug benefit. Do not assume that more insurance always makes refills simpler.

Bring these questions to the review.

• Are Parts A and B active for the person being reviewed?
• Who will file TFL reimbursement claims?
• How would the exact plan affect current doctors?
• Is an additional drug benefit useful in this situation?