LAW OF THE LAND: Medicare Part B and TRICARE for life – why you need to pay attention

William L. Martin III
William L. Martin III

Title XVIII of the Social Security Act (Act) provides for federal health insurance for the aged and disabled under Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B) programs. Generally, individuals are eligible to enroll in the Part B program when they reach age 65 and are either citizens or resident aliens continuously living in the United States for the preceding five years.

An eligible individual may enroll in Medicare only during specific time periods. An individual may first enroll during an initial enrollment period that begins three months before and concludes three months after age sixty-five, if citizenship and/or residence eligibility requirements are met.

If you do not enroll during the initial enrollment period, the Act provides for enrollment during general enrollment periods each year thereafter, from January 1 through March 31. Unless you qualify for a special enrollment period, the Act assesses a 10 percent premium increase for each full 12-month period following the initial enrollment period in which you could have been, but were not enrolled in, Medicare Part B.

You can terminate your Medicare enrollment on written notice. Those who enroll late, or who re-enroll after their coverage has been terminated, may have to pay a ten percent premium surcharge for each twelve-month period during which the individual could have been but was not enrolled in Medicare.

TRICARE for Life is the Department of Defense benefit plan for military retirees age 65 years or older. Congress enacted TRICARE for Life, which re-established TRICARE health care coverage as a wraparound to Medicare for military retirees, age 65 and older. To take advantage of the TRICARE for Life program, military retirees must be enrolled in Medicare Part B.

The bottom line is this. If you are a retired military member, like me, who is using TRICARE for your medical coverage, it is important that you enroll in Medicare Parts A and B when you turn 65. If you fail to enroll in both Parts, you will not be eligible for TRICARE for Life.

There is an exception if your failure to enroll was unintentional, inadvertent, or erroneous and was the result of the error, misrepresentation, or inaction of an officer, employee, or agent of the Federal Government. A difficult hurdle to meet.

Bill Martin is a former United States Air Force pilot and senior attorney for the Federal Deposit Insurance Corporation. He is currently a partner in the law firm of Keefe, Anchors & Gordon in Fort Walton Beach.