Heads Up For Anyone Over or Approaching Age 65

This year I will reach age 65.  I'm retired Navy and have military health insurance known as TRICARE and I have been very happy with it, but when I reach age 65 TRICARE requires that I enroll in MEDICARE and my TRICARE coverage becomes secondary to MEDICARE.  

This specifically applies to military retirees, but may also apply (with different procedures) to anyone on MEDICARE and who has supplemental insurance coverage since all supplemental health plans (including TRICARE) are predicated on the concept that they will cover some portion of medical costs not covered by MEDICARE.  If no claim is filed with MEDICARE, it appears that no payment will be made by the supplemental plan.

Every health plan I know of requires the insured to enroll in MEDICARE parts A & B (Part D is another matter).  Typically, when you reach age 65 and/or retire you become subject to MEDICARE.   If you are covered by an employer plan; when you retire, either your health plan ends and you may purchase a MEDICARE supplemental plan or your employer may sponsor a supplemental plan.  In either case; MEDICARE becomes your primary plan and any other plan (including TRICARE) becomes secondary.

I recently helped an elderly friend who had fallen and broken some ribs.  He was otherwise healthy, takes no regular medication and did not have a primary care physician.  It took three hours of phone calls to finally find a doctor who would accept him as a new patient.  He is on MEDICARE Parts A & B and has a supplemental plan.

MEDICARE payment schedules are already so low now, many health care providers don't want to commit themselves to a MEDICARE contract and those that are already on contract refuse any new MEDICARE patients.  

And it's going to get worse;  the 'Affordable Health Care Act' has opened MEDICAID coverage availability to millions more people and funding for MEDICAID will, at least partially be taken from MEDICARE funds.  I assume this will obviously result in MEDICARE paying less and less until no health care providers will accept a patient under MEDICARE provisions.

So that got me to thinking: if it's so hard now to get a health care provider to treat a patient on MEDICARE, what are the implications for me when I must enroll in MEDICARE as my primary insurance.  Will TRICARE as my secondary insurance still pay?

So I sent the following question to TRICARE:  "If MEDICARE becomes so unpopular that few or no health care providers in my area will accept me as a MEDICARE patient will TRICARE FOR LIFE cover my medical treatment without a MEDICARE claim being filed?"

The response from TRICARE was flagged as confidential and I'm not permitted to disclose it, but basically, my general understanding is that if I can't find a health care provider who is under contract with MEDICARE and will file a claim, I could face some huge personal costs and I would assume this probably applies to anyone with a MEDICARE supplement health plan such as those sold by AARP.  

This is an issue being completely ignored by the media including FOX News.  We keep hearing how bad the Obamacare web site is, the coverage cancellations, costs, etc, but no one is revealing how devastating Obamacare may be to MEDICARE and potentially leave everyone over the age of 65 with no affordable health care whatsoever.

BTW, you may recall AARP was a prominent advocate for enactment of the 'Affordable Health Care Act', and my guess is that they knew the new law would undermine MEDICARE and make their supplemental health plans virtually worthless.


  1. NavyDavy,

    email me at a little-used account and I'll keep an eye out for your message: txseaspook@yahoo.com

  2. NAVYDAVY if you want to communicate with me, you need to send an email to above address. Eventually I will forget and not check it anymore.

    1. I did. I did. On 2/13/2004 10:09:14 PM. And I just did it again on 2/16/2014 2:37:41 PM. If no joy we'll go to plan B.