Tricare for life - anyone using it now?

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
Post Reply
User avatar
corn18
Posts: 916
Joined: Fri May 22, 2015 6:24 am

Tricare for life - anyone using it now?

Post by corn18 » Mon Oct 26, 2015 3:39 pm

I made the mistake of visiting the AARP site and plugging in my data to calculate my health care costs in retirement. Wow! Based on our current health and desired retirement age, our medical costs were forecast to be $1.3M from age 62 to 79 (me dead) and 83 (wife dead). It said that Medicare will cover about $700k and I had to pay for the rest. I wasn't planning for that high medical expenses.

Then I started looking into my retirement health care I have (and currently use): Tricare for Life (military retiree). Turns out, it pays everything Medicare doesn't. I just have to pay the medicare premiums, and it covers all the rest. That means I only pay $104.90 a month and that's it. Is that right? Seems like a great deal to me and if true, I feel blessed to have such a plan available. Of course, it could change, but who knows?

Any BH's have Tricare for Life? Would love to confirm this.

I still need to figure out LTC (nursing home scenario), but after looking at premiums for LTC, I was planning to self-insure.

Appreciate your feedback.

Tom

User avatar
mickeyd
Posts: 4598
Joined: Fri Feb 23, 2007 3:19 pm
Location: Deep in the Heart of South Texas

Re: Tricare for life - anyone using it now?

Post by mickeyd » Mon Oct 26, 2015 4:24 pm

Any BH's have Tricare for Life? Would love to confirm this.
Hey Tom,

I have been using TFL (along w/MC) for about 5 years and my only health care expenses have been the Medicare monthly premium, which is a few $ over $100/month. Between Medicare and Tricare, they pay for 100% of my doctor, lab etc. costs.I get my meds from a local military hospital so there is no cost for them at all. I pay for my dental visits with cash. No need for a medigap policy.
for LTC, I was planning to self-insure.
That works for me also. LTC is too costly. I can assume that risk.
Part-Owner of Texas | | “The CMH-the Cost Matters Hypothesis -is all that is needed to explain why indexing must and will work… Yes, it is that simple.” John C. Bogle

Ducky Momo
Posts: 27
Joined: Sun Aug 18, 2013 12:42 am

Re: Tricare for life - anyone using it now?

Post by Ducky Momo » Mon Oct 26, 2015 4:34 pm

My father is Navy retiree 20 years. Both he and my mother (up until her death) used TFL as a supplement to medicare. You do have to be enrolled in both medicare A and B to qualify for TFL so be sure to sign up when it is time to do so.

I don't know if there is another more efficient way to do this, but anytime they pay out of pocket (er visit, doctors copay, lab visits etc), they would photocopy the receipt, fill out DD form 2642 and mail both to the TFL claim reimbursement office. Less than a month later, they receive a check in the mail for the claim amount they submit. They have medicare through Kaiser.

Prescription reimbursement I found is a little more trickier to get, so maybe someone else can chime in on that. But if you live within reasonable driving distance of a dispensary (active duty dispensary doesn't matter) they can fill you meds for free. You would have to call them directly to see what their protocols are though in order to proceed.

Otherwise, you can sign up for prescription refills online through the tricare website. Should ship to your house for free as long as you're willing to do the legwork to submit the appropriate forms.

TFL is fantastic and I really encourage you to read as much as you can about it because it has saved my parents so much money in their golden years.

User avatar
corn18
Posts: 916
Joined: Fri May 22, 2015 6:24 am

Re: Tricare for life - anyone using it now?

Post by corn18 » Mon Oct 26, 2015 4:42 pm

You guys are making me smile real big right now. I truly feel blessed. I feel somewhat guilty for being taken care of so well. Between a COLA adjusted pension starting at age 42 and really cheap healthcare for life, I should be thanking everyone else. Those two things together are worth about $1.5M in retirement savings.

Tom

User avatar
mickeyd
Posts: 4598
Joined: Fri Feb 23, 2007 3:19 pm
Location: Deep in the Heart of South Texas

Re: Tricare for life - anyone using it now?

Post by mickeyd » Mon Oct 26, 2015 4:46 pm

I don't know if there is another more efficient way to do this, but anytime they pay out of pocket (er visit, doctors copay, lab visits etc), they would photocopy the receipt, fill out DD form 2642 and mail both to the TFL claim reimbursement office. Less than a month later, they receive a check in the mail for the claim amount they submit.
It's all done electronically now. No paperwork, no coordination necessary. Both MC and TFL send members an EOB explaining that any balance is not payable by the patient.
Part-Owner of Texas | | “The CMH-the Cost Matters Hypothesis -is all that is needed to explain why indexing must and will work… Yes, it is that simple.” John C. Bogle

User avatar
mickeyd
Posts: 4598
Joined: Fri Feb 23, 2007 3:19 pm
Location: Deep in the Heart of South Texas

Re: Tricare for life - anyone using it now?

Post by mickeyd » Mon Oct 26, 2015 4:49 pm

I should be thanking everyone else.
Thanks for YOUR service Tom. Someone thinks you are worth it.
Part-Owner of Texas | | “The CMH-the Cost Matters Hypothesis -is all that is needed to explain why indexing must and will work… Yes, it is that simple.” John C. Bogle

User avatar
Lee Saage
Posts: 201
Joined: Wed Jun 13, 2007 6:25 pm
Location: Georgetown, TX

Re: Tricare for life - anyone using it now?

Post by Lee Saage » Mon Oct 26, 2015 5:42 pm

I'm trying to use Medicare and Tricare-for-Life but without success so far. I retired in July and my employment-based health insurance ended in August, the same month Medicare Part B began. Medicare, however, refuses to acknowledge that I no longer have "third-party" health insurance despite assurances from my previous employer that Medicare has been so informed. Multiple calls to Medicare have only produced a declaration that once my previous employer so notifies Medicare, all will be well. Somehow the sending of the notice by my prior employer and the receiving and acknowledging of the notice by Medicare have not synced. Right now, none of my medical claims are being accepted or paid by anyone. I hope this is merely bureaucratic inertia and things will sort themselves but who knows.
Most of my money went to fast cars, fast living and good wine. The rest I just wasted.

User avatar
BL
Posts: 8240
Joined: Sun Mar 01, 2009 2:28 pm

Re: Tricare for life - anyone using it now?

Post by BL » Mon Oct 26, 2015 10:28 pm

We have had good experience using Medicare + TriCare for Life. Almost everything has been covered. A few sleeping pills, and co-pays at local pharmacy for immediate needs rather than using mostly free mail order have been about the only costs.

I kept expecting some costs due to years beginning both January (Medicare) and October (TFL), but no major problems so far. The co-pays seem to get covered somehow.

Not covered would be vision, hearing, and teeth upkeep, as well as LTC.

User avatar
Peter Foley
Posts: 4498
Joined: Fri Nov 23, 2007 10:34 am
Location: Lake Wobegon

Re: Tricare for life - anyone using it now?

Post by Peter Foley » Mon Oct 26, 2015 10:35 pm

My mother in law was a Naval Officer during WWII. She is currently on Tricare. She is 95 and is relatively healthy for her age. Tricare has been great for her for many, many years.

User avatar
dratkinson
Posts: 4298
Joined: Thu Jul 26, 2007 6:23 pm
Location: Centennial CO

NOSTRA (glasses) and Express Scripts (meds-by-mail)

Post by dratkinson » Mon Oct 26, 2015 10:43 pm

I have Medicare, TFL, no 3rd-party insurance.

Ophthalmologist and Rx covered, but not glasses.

NOSTRA was suggested for glasses but have never used it: http://www.med.navy.mil/sites/nostra/Pages/default.aspx

Dental is fee-for-service as it has been cheaper than insurance.


TFL is "no co-pays", if memory serves. At least this has proven to be my case, so far.


Meds. If not close to a base pharmacy, TFL prefers we use meds-by-mail from Express Scripts: https://www.express-scripts.com/

If you don't (didn’t) know about ES (my case) and purchase your meds locally (drugstore), you will get a discount because of TFL, but then receive a Statement of Benefits letter from TFL/ES... and a suggestion that you sign up... or lose some benefits for exotic meds. TFL has so far paid all my Express Scripts costs.


ES automated telephone Rx processing system. According to a pharmacist (I asked), a Rx system links pharmacies/doctors/hospitals (like ACH links financial institutions?). ES is a part of this system.

Your doctor inputs your Rx into the ES system (it may be a fax number, don’t know). You use your telephone to access the ES Rx reorder system, and it works very much like using a base pharmacy telephone Rx reorder system.

N.B. If there is a problem with the ES automated system, it sends you a letter... meaning you will know about the problem 2-weeks later.

N.B.: The ES automated system seems to stop working after it sends out an automated letter. "Rx backordered" status letter: nothing more happens until you call an ES Customer Service Representative. "Attempted to reorder too soon" status letter: nothing more happens until you call a CSR. (Of course, this could be because I told ES to stop sending meds until I called them. See next point.)


Forward storage location. ES will send meds automatically without you needing to call them. However, once the ES automated system kicked in, it felt like ES was trying to use me as a forward storage location, and pushing meds to me. So I called a CSR to have them stop the automated shipments, and to wait for my call before shipping more.

So automated shipments, or wait-for-my-call shipments. Your choice.


Reorder meds at 1 month, not 2 weeks. ES wants you to wait until you have 2 weeks of meds remaining before reordering. Two weeks is not enough time. Why? The ES automated system will not tell you when meds are on backorder. So if meds are on backorder, you will receive an ES automated letter telling you of the backorder status, instead of the meds. That ES letter will take 2 weeks to arrive... meaning you are out of meds if you reordered at the 2 week point. And after your call to a CSR, may need to scramble to refill your Rx locally... or wait an additional 2 weeks for meds to arrive from ES if no longer on backordered status. So ordering at the 1-month point seems to give more lead time to allow things to work more smoothly.


Local Rx fill. Assuming ES backordered status, a local drugstore can call and pull your Rx from ES (meaning ES no longer has your RX), or get a new Rx from your doctor. So your Rx can be easily moved or replaced, to be filled locally. Your local pharmacy only needs the phone number (ES or doctor) and your Rx number to do this. (Hint: travel with these numbers.)


Count your meds when they arrive. When your ES order arrives, count your meds. Why? The ES automated system "knows" how much was sent and your dosage, so if your order was short (human filled), you will run out before the next reorder is due. And your early reorder attempt will result in an automated letter saying you "attempted to reorder too soon"... no meds. Then you get to call a CSR and explain that what the system "knows" is wrong. It is simpler to correct any problem sooner, rather than later. After the CSR correction call, any missing meds will be sent to sync you with what the ES system "knows", and your next reorder will process smoothly.


DD Form 2642. Thanks for the heads up about "...DD form 2642 and mail both to the TFL claim reimbursement office". Didn't know about that. The TFL/ES/SoB letter/enrollment process was quick enough than any out-of-pocket cost was small for me. I'll use this information the next time meds are backordered and filled locally.


Bottom line. So with the ES automated system seemingly trying to push meds, notification of problems 2-weeks after the fact, calling to ES CSR to get in sync with the system, and local purchases to move/fill/reimburse Rx/cost,... your first 6 months will require some learning on your part.

These seem to be the steps required in dealing with ES and meds by mail.
  • --Call ES CSR to set up your account before your need, and provide ES Rx phone order number to doctor. Or if your need is immediate and you can't wait 2-4 weeks, then fill Rx locally and wait for the TFL/ES letter or call ES afterwards. ES will pull your Rx from local pharmacy to fill reorders.

    --Call ES CSR to stop ES automated system from shipping any excessive meds.

    --Call ES automated Rx phone system to reorder meds at the 1-month point. Expect meds or letter at 2 weeks. (May not need to call if you allow automated shipments. Have not asked the question of ES so don't know how automated shipping schedules and backordered status letters work together. Do they wait until 2-weeks before you run out and then ship or mail a letter saying they can't?)

    --If ES meds arrive. Count meds and call ES CSR to correct any mistakes early. Missing meds will be sent to sync you with ES system.

    --If ES letter arrives, instead of meds. Call ES to talk to CSR. CSR has access to order status and can impose some order on the automated system: can override "reordered too soon" status, or can tell you that you will need to fill meds locally because of continued backordered status or shipping delays.

    --If you fill Rx locally. Submit form 2642 for out-of-pocket cost. (Haven’t done this yet.)
Meds-by-mail is nice. The ability to move Rx around by phone is nice: doctors and pharmacists do most of the work. And the ES system is not that bad once you break the code.
d.r.a, not dr.a. | I'm a novice investor, you are forewarned.

User avatar
BL
Posts: 8240
Joined: Sun Mar 01, 2009 2:28 pm

Re: Tricare for life - anyone using it now?

Post by BL » Mon Oct 26, 2015 11:30 pm

I go online to ES and have automated shipments, so I don't have to interact with them at all. The doctor renews subscription on his computer, and all works very well. (There was one little mixup a couple years ago when I didn't get expected refills, but a phone call straightened that out.)

Post Reply