How to get SilverSneakers with TriCare for Life
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 32 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 since 2019, so that’s why most TFL members are not aware that they exist.
Humana®️ USAA 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%.
I do not offer every plan available in your area. Please contact Medicare.gov or 1-800-Medicare to get all of your options.
Give me a call at 303-335-9611
or email firstname.lastname@example.org