Will Disability Benefits Affect Your TRICARE Coverage?

Submitted by Kyle on Thu, 11/03/2011 - 10:17

TRICARE is military health insurance offered to active military members, their families, and military veterans and their families. Of course, there are limitations to coverage, but TRICARE continues to be the leading health care program that serves uniformed service members.

TRICARE recipients will see a slight rise in fees and co-pays starting in 2012, which have not been adjusted since 1994. An annual fee for military retirees enrolling in certain TRICARE health plans has gone up between $2.50 a month to $5.00 a month for families. Such modest increases don't warrant much alarm for TRICARE beneficiaries. However, what happens if you are receiving Social Security Disability?

Social Security Disability and TRICARE

SSDI and SSI benefits are available for individuals who can't work because they have a disabling medical condition expected to last at least one year or that may result in death. When disability claims are approved by the Social Security Administration, disability payments start after the beneficiary's sixth month of disability. However, depending on medical condition and circumstance, individuals diagnosed with certain conditions may qualify almost immediately.

Individuals eligible for Social Security Disability may also already be enrolled in a variety of TRICARE health programs. Many individuals are confused about how these two work together. Actually, when TRICARE beneficiaries become eligible for Medicare and/or are enrolled in Medicare Part B, the Social Security Administration notifies DEER (Defense Enrollment Eligibility Reporting System) regarding their enrollment.

Active military and retired military personnel are recommended to take the time to learn about different TRICARE health programs including TRICARE Prime and TRICARE Standard, as well as their eligibility for TRICARE for Life, or TFL.

It's also important for beneficiaries to know that they can be eligible and qualify for both disability benefits and TRICARE services. In cases where individuals have both, TRICARE acts as a supplemental or secondary insurance. Social Security beneficiaries become eligible for Medicare benefits at age 65, regardless of what they do for a living, as long as they've paid into the system for a certain number of quarters.

Bottom line is that individuals who are currently TRICARE beneficiaries and enroll in Medicare Part A and Part B or apply for disability and whose DEER registration is updated will have DEER report their eligibility for TRICARE For Life. That will then become effective the same date as Medicare entitlements become effective for the TRICARE recipient.

Individuals who are eligible for Medicare services, Social Security benefits and Social Security Disability Insurance benefits will transition to either TRICARE Standard or TRICARE For Life, depending on individual scenario. For more information regarding the affect that Social Security Disability Insurance benefits may or may not have on your TRICARE coverage, contact your DEER or TRICARE representative.

So many different of situations and scenarios are determined on an individualized case-by-case basis. Research your options in regard to Social Security Disability Insurance, different TRICARE coverage health plans, and Medicare eligibility and enrollment for Medicare Parts A and B.