Who is Eligible to get Benefits under TRICARE for Life (TFL)?
The Department of Defense implemented TRICARE For Life (TFL) in 2001 to help Medicare-eligible military retirees and their Medicare-eligible dependents, widows, or widowers pay medical costs not covered by Medicare.
TRICARE For Life is a secondary payer to Medicare, which means that when a benefit is covered by both plans, as is usually the case, Medicare will pay the provider first, and TFL will pay second. TFL’s share may include Medicare deductible and cost-sharing amounts.
TRICARE for Life is a primary payer in situations where a health service is a TRICARE benefit but is not covered by Medicare. For example, TRICARE would normally be the primary payer in situations involving prescription drug charges and services performed in Veterans Affairs facilities.
When a health care service is covered only by Medicare and not by TRICARE, you will be responsible for any amounts not covered by Medicare. When a benefit is covered only by TRICARE, you will be responsible for TRICARE cost-shares and deductibles.
Only medical services deemed medically necessary are covered by TFL.
Such services must fall under the category of skilled care. As a result, custodial care is not covered by TRICARE for Life. Chiropractic services also are not covered by TFL.
To be eligible for TFL benefits, you must be both Medicare-eligible and TRICARE-eligible. You must also be enrolled in Medicare Part B unless you are the Medicare-eligible spouse of an active duty service member.
For more information about TRICARE for Life, call 1-866-773-0404 or visit the official TRICARE For Life website.
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