TRICARE: Enrollment of the Department of Defense's TRICARE Beneficiaries in Medicare Part B Page: 1 of 22
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Accountability * Integrity * Reliability
United States Government Accountability Office
Washington, DC 20548
June 30, 2006
The Honorable Pete Stark
Ranking Minority Member
Subcommittee on Health
Committee on Ways and Means
House of Representatives
The Honorable Benjamin L. Cardin
House of Representatives
Subject: TRICARE: Enrollment of the Department of Defense's TRICARE
Beneficiaries in Medicare Part B
TRICARE is the Department of Defense's (DOD) health care system for active duty
and retired uniformed service members and their families. TRICARE consists of four
separate programs. Three of these programs-TRICARE Prime, a managed care
option; TRICARE Extra, a preferred provider option; and TRICARE Standard, a fee
for service option-cover active duty personnel, their dependents, and retirees under
age 65. Prior to 2001, TRICARE beneficiaries would lose their TRICARE coverage
when they reached age 65, and Medicare-the federal health insurance program that
provides medical benefits to over 42 million elderly and disabled Americans-would
become their primary health insurer. However, in 2001, the Congress expanded
TRICARE by establishing a fourth program, known as TRICARE for Life (TFL). TFL
provides supplementary health care coverage for TRICARE beneficiaries' who are
entitled to Medicare Part A,2 and enrolled in Part B. It pays for many services that
Medicare only partially covers. While TRICARE beneficiaries do not have to pay for
their TFL coverage, they are required to pay premiums for Medicare Part B.
DOD generally encourages TRICARE beneficiaries to enroll in Medicare Part B when
they reach age 65 or when the Social Security Administration (SSA) determines that
they are disabled and they have been receiving disability benefits for 24 months.
Those who do not enroll in Part B when first eligible must wait, like other
beneficiaries, for Medicare's general enrollment period, which is held annually, from
January 1 to March 31, with coverage beginning on July 1 of that same year. In
'Hereafter, we use the term TRICARE beneficiaries to include military retirees and their dependents
and survivors who are entitled to Medicare Part A.
2Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, and certain home health
services. Part B covers certain physician, outpatient hospital, laboratory, and other services. Another
component of the Medicare program is Part D, which provides prescription drug coverage for
GAO-06-489R TRICARE and Medicare Part B
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United States. Government Accountability Office. TRICARE: Enrollment of the Department of Defense's TRICARE Beneficiaries in Medicare Part B, text, June 30, 2006; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc301514/m1/1/: accessed December 17, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.