How to get SilverSneakers with TriCare for LifeSteve Schrader
SilverSneakers is not included with Medicare Part A and B or with Tricare for Life(TFL), but is included in some zero premium Medicare Part C plans, also called Medicare Advantage Plans. Currently there are over 26 million Medicare clients on Part C plans nationwide, which are required to provide the same benefits as Part A and B, but can also include vision, hearing, dental coverage and SilverSneakers.
TFL, started in 2001, provides two great benefits for its members-
(1) it pays the copays and deductibles that Medicare Part A and B OR Part C does not cover.
- TFL is the secondary payor.
(2) provides excellent prescription drug coverage with Express Scripts.
The first thing I want to make clear is that I am NOT recommending or suggesting you “drop TFL”, “lose TFL”, “mess up TFL” etc.
Most TFL members assume that their only option is stay on original Medicare Part A and B to use their Tricare for Life benefits, but the fact is you can also enroll in a zero premium Medicare Part C plan that is designed for veterans, and still keep your TFL benefits. These plans have only been out a couple years so that’s why most TFL members are not aware that they exist.
Humana®️ Honor Plan and the UnitedHealthcare®️ Patriot Plan are zero premium Medicare Part C plans designed for veterans. These plans do NOT include drug coverage because you already have Express Scripts, so nothing is affected with your current drug coverage.
Currently, TFL is secondary to Medicare Part A and B, and STAYS secondary if you enroll in a Part C plan. Under your current plan (Medicare Part B) Medicare pays 80% and you have a copay of 20%. The 20% copay gets billed to TFL and they pay it. Medicare Part C plans do not use a 80/20 structure, they cover all costs except a flat copay amount ($20 for primary care visit- $40 for specialist – example). Your doctors office bills TFL for your flat copay amount.
TFL still covers your copays on a Part C plan.
TFL members have a copay now, it is 20% of the Medicare approved service.
Copays on a Part C Plan are a flat amount instead of 20%.
Your doctors office will bill TFL for your copays, like they do for all their clients.
One of the major benefits with the Part C plans designed for veterans is the Medicare Part B premium credit. In 2022, most Medicare members will be charged $170.10 per month for their Medicare Part B premium, which is deducted from your social security check each month or paid quarterly if you are not receiving social security yet.
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