3 minute read
Benefits Brief
TRICARE or TRICARE for Life and FEHB Advantages
Military retirees and their eligible family members are covered by a health care program known as TRICARE or TRICARE for Life (TFL). Civilian federal employees are eligible to choose from many health care plans though the Federal Employees Health Benefits (FEHB) program. Military retirees who work in federal civilian jobs may choose to enroll in an FEHB plan for themselves and their eligible family members in addition to having coverage under TRICARE. Generally, TRICARE covers children until age 21 or 23 if in college, whereas FEHB will cover children to age 26.
For more details on family eligibility under TRICARE, visit https://www.tricare.mil/. For more details on family eligibility under FEHB, visit https://www. opm.gov/healthcare-insurance/ healthcare/reference-materials/ reference/family-members/.
TRICARE or TFL provides excellent health care. Federal civilian employees who are eligible for TRICARE may choose to enroll in an FEHB plan that may provide additional benefits or added flexibility. When combined with TRICARE, FEHB will become the primary payer.
Coverage under TRICARE counts toward the five years necessary to continue FEHB into retirement if you are enrolled in an FEHB plan on the date of retirement. As a retiree, you may suspend your FEHB coverage in retirement under certain circumstances such as when you are covered by TRICARE, TRICARE for Life or CHAMPVA (health benefits for the spouse or surviving spouse of—or child of—a veteran with disabilities or a veteran who has died). While suspended, you will not be covered and will not pay premiums for your suspended FEHB plan. Retirees may use Retirement and Insurance Form RI 79-9 to suspend their FEHB coverage. (https://www.opm.gov/forms/ pdf_fill/ri79-9.pdf) To cancel the suspension, use OPM Form 2809 and Qualifying Life Event 2C (involuntary loss of coverage) or 2D (Open Season) to reenroll.
Federal employees who are turning 65 may choose to use FEHB coverage instead of TFL, as FEHB plans do not require enrollment in Medicare Parts A and B to maintain coverage. If you delay enrollment in Medicare Part B and rely solely on your FEHB coverage through your or your spouse’s current employment, you may sign up for Medicare Part B during the Special Enrollment Period (SEP) without penalty before you retire or within eight months following your retirement. Your TFL coverage begins on the first day you have both Medicare Parts A and B coverage. To use the SEP to enroll in Medicare Part B, you will need to contact Social Security to set up an appointment to provide proof that you were covered by “current employment” health coverage. You will need forms CMS 40-B (Application to enroll in Medicare Part B) and CMS L-564 (Request for Employment Information).
Section 9 of all FEHB brochures provide details on how FEHB coordinates with TRICARE. Find the brochure at https://www.opm.gov/ healthcare-insurance/healthcare/ plan-information/compare-plans/
Now is an excellent time to review your current health coverage and compare the benefits of your FEHB plan options. Open Season will begin on November 14 and continue through December 12. Open Season elections will be effective January 1, 2023, for retirees and most active employees this year. For Postal Service employees, the 2022 leave year ends January 13, 2023, with Open Season changes taking effect on January 14, 2023.
OPM has a number of Q&As specific for FEHB and TRICARE, CHAMPVA, TRICARE for Life on their website: https://www. opm.gov/faqs/topic/insure/. Scroll down to the bottom of the “refine by subtopic” column to find them.
—MICHELE BOLLIER IS A RETIREMENT AND BENEFITS SPECIALIST WITH RETIRE FEDERAL.
