Please note that this is a best effort to explain the Medicare Sign-up process and how it ties with Tricare. Please let me know if you find any errors.

I. What are the Medicare parts, do I need them

Part A (Hospital Insurance): Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.

Part B (Medical Insurance): Helps cover:

• Services from doctors and other health care providers
• Outpatient care
• Home health care
• Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
• Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)

Part C (Medicare Advantage): You need to shop these, BUT, you shouldn’t need PART C or any other supplemental if you have Tricare. Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D.

In most cases, you’ll need to use doctors who are in the plan’s network.

Plans may have lower out-of-pocket costs than Original Medicare.

Plans may offer some extra benefits that Original Medicare doesn’t cover — like vision, hearing, and dental services.

Part D (Drug coverage): Helps cover the cost of prescription drugs (including many recommended shots or vaccines). You join a Medicare drug plan in addition to Original Medicare, or you get it by joining a Medicare Advantage Plan with drug coverage. Plans that offer Medicare drug coverage are run by private insurance companies that follow rules set by Medicare.  You shouldn’t need Part D if you have Tricare

II. How does Medicare align with Tricare

Once enrolled, Medicare becomes your primary health care payer. If eligible for Tricare, you will automatically be transferred from Tricare Select (or whatever you had) to Tricare for Life. Supposedly this happens automatically, but check when you get your new ID card – see When do you sign up below. The entire billing process is supposedly made simple – Medicare pays first, whatever they do not cover they directly forward to Tricare for Life.  Tricare for Life covers all the rest, even the deductible (see coverage table link below). This is supposed to make the billing simple for your doctor’s office, they do not need to do a second billing to Tricare.

III. Timeline

USCG ID card:

If you are retired, then you will notice that the front of your ID card says the expiration if INDEF, but on the back there is an expiration date.  That date should be the last day that you would NOT be eligible for Medicare.  The whole point of this is to get you to enroll in Medicare, then go in and get a new ID card – providing them your Medicare number so that they can automatically transfer you from Tricare Select to Tricare for Life.  Note, if you are married and you are older than your spouse, then when do all of this and move to Medicare/Tricare for Life, your spouse will stay on Tricare Select and your monthly payments should be reduced by 50%.  Same goes if your spouse if older than you – they do this sign up process and move to Medicare/Tricare for Life while you stay on Tricare Select.

When do you sign up?

Your window to sign up is three months prior to your 65^th birthday.  Say your birthday is October 5, your window to enroll opens July 1^st. However, if your birthday falls on the first of the month (October 1), then your window is one month earlier – June 1^st.  You should sign up as soon as possible once your window opens.  It takes up to a month for the Social Security Administration (SSA) to process your request. 

When does coverage begin?

Assuming all went well with your enrollment process, then your Medicare/Tricare for Life coverage will begin the 1^st day of the month of your 65^th birthday (the Oct 5 birthday example – coverage begins Oct 1).  However, comes in to play again – if your birthday is the 1^st of the month (Oct 1), then your Medicare/Tricare coverage will begin September 1^st.

Signing up

Signing up cannot be any easier.  Again, do this as soon as you can.

Step 1: create an account at SSA - https://secure.ssa.gov/RIL/SiView.action

Step 2: Log into your mySSA account and complete the Medicare application – I can’t go back and do it, but I think all I needed was the city/state of my birth an SS number.

Step 3: wait while they process your application (takes a few weeks)

What to do once you get your Medicare card

Guard this number like you would your Social Security Number.  Scammers are always trying to get this so that they can submit false claims.

Once you get you card/number, THEN go to get your new retiree ID card. Renewing your ID after you are approved for Medicare gets you an id card with a lifetime expiration date. If you (or your spouse) get your new ID card earlier, then you will need to go back and get another one with no expiration date.

My story: My birthday is in December – I signed up for Medicare on September 1. I was approved about September 20^th. I made an appointment and got my new lifetime military retiree ID card.  I was also automatically shifted from Tricare Select to Tricare for Life (this was confirmed when I was getting my ID card) with my premium being reduced by 50% (my wife stayed on Tricare Select).  My wife will become eligible for Medicare in the fall of 2025 so she will have to also do this same process before she can get her lifetime military ID card and shifted to Tricare for Life.

IV. Medicare costs

Paying: If you are receiving Social Security payments, then the Medicare premium should be automatically taken from those payments.  If not, then you need to either pay by check or set up an automatic bank withdrawal.

What are Medicare and Tricare costs? Note: these assume that you are Medicare eligible (worked 40 quarters and age 65) and these costs change each year

Part A: free

Part B: $164.90 each month – you may owe more depending on your income – signing up in 2023, they will look at your 2021 income that you filed on your taxes in 2022 – see this web page for more information:  https://www.ssa.gov/benefits/medicare/medicare-premiums.html

Part C: See this web site for Plan C options:  https://www.medicare.gov/basics/costs/medicare-costs

Part D: This is also income dependent.  https://www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-part-d-costs/part-d-costs-for-those-with-higher-incomes

A summary and further explanation of these costs can be found at:  https://www.medicare.gov/basics/costs/medicare-costs

Please let me know if you find any of this to be inaccurate.

TimPowersAK@gmail.com   907.209.8578