Guide Contents

These are the sections of this guide that appear in order on this page.

  • Medicare & Tricare – Important Facts To Know
  • The Parts Of Medicare
  • Medicare Advantage
  • Standard Medicare Vs. Medicare Advantage
  • Featured Heroes Tesmionials
  • Request Info On Available Plans & Benefits
  • General Frequently Asked Questions
  • Medicare Advantage Frequently Asked Questions

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Medicare And Tricare

As a retired military service member or their spouse, you will likely have Tricare as your medical and prescription coverage. Prior to becoming eligible for Medicare, you’ve probably been using this as your main coverage. But, when you become eligible for Medicare at age 65, this changes. When you start Medicare it becomes your primary medical insurance and Tricare your secondary. Tricare also continues to provide you with prescription coverage. As a Tricare For Life recipient, it’s important to know that you must enroll in Medicare to maintain your Tricare benefits. You can enroll in Medicare 3 months before the month that you turn 65 and it will take effect the month that you turn 65. Here are some important facts that you need to know.

Facts To Know

  • When you become eligible for Medicare A & B, it will become your primary medical coverage for doctors care, treatment, and hospitalization. You can apply to enroll in Medicare 3 months before the month you turn 65. If you are receiving Social Security you don’t need to apply, you’ll be automatically enrolled.
  • Tricare becomes your secondary insurance to Medicare and will cover all medical costs not paid by Medicare, essentially giving you 100% coverage (For Medicare A & B services).
  • Tricare continues to provide you with prescription coverage.
  • With Medicare, you have two main choices as to how you are covered. You can choose to get Medicare directly through the government (Original Medicare) or through private health plans known as Medicare Advantage.
  • Tricare can be billed as your secondary insurer for copays with either Original Medicare or private Medicare Advantage.

Need To Know

To maintain your Tricare benefits, you must enroll in Medicare when you become eligible.

The Parts Of Medicare

Medicare has 5 parts, with the main ones being Parts A & B. Medicare Part A covers inpatient hospitalization, skilled nursing facility, and home health care. Medicare Part B covers doctors and outpatient treatment. At a minimum you’ll want parts A & B and you can select from the 3 other parts based on your wants & needs.

The Other 3 Parts

  • Part C – More commonly known as Medicare Advantage, these are private insurance plans. You have the choice of being covered directly through Medicare or a Private Insurer.
  • Part D – Medicare prescription pharmacy benefits. Medicare does not provide coverage directly but instead through private insurers. In most cases Part D is not needed by Tricare recipients.
  • Supplements – Medicare Supplements are insurance plans that supplement Medicare A & B. They are offered by private insurers and help cover medical costs. Tricare provides the same function, so in most cases, Medicare Supplements aren’t needed by Tricare recipients.

In many cases Tricare provides prescriptions at an affordable cost, however, in rare cases it’s beneficial for you to have drug coverage under Medicare as well.

Medicare Advantage

How Tricare Recipients Get The Most Medicare Benefits For The Lowest Cost

With Medicare you have the choice of getting your benefits directly through the government (Original Medicare) or through a private insurer (Medicare Advantage). Both Original Medicare and Medicare Advantage include Part A coverage for hospitalization and Part B for doctors & outpatient care. Tricare can be billed as your secondary insurance for either option. Original Medicare is “one size fits all” and the same for everyone in the country. Medicare Advantage, however, gives you various choices that may be a better fit for your unique situation.

The “Advantage” in Medicare Advantage is that they include more benefits than Original Medicare, at the same or lower monthly cost. The additional benefits you can get with Medicare Advantage include;

  • Dental, Vision, and Hearing Aid coverage.
  • Silver Sneakers – Gives you free access to exercise facilities and online exercise videos.
  • Part B Giveback $ – This is a benefit included with some plans that gives you a monthly dollar amount to help you pay your Medicare cost.
  • Prescription – There are Medicare Advantage options that include pharmacy coverage and some that do not.

Tricare continues to provide you with good prescription coverage, so in most cases, Medicare prescription coverage is not needed. This allows you to choose a Medicare Advantage plan without prescription coverage, which has it’s own unique benefits.

Tricare As Secondary

Tricare can be your secondary insurance to Medicare Advantage and cover your medical copays. Medicare Advantage plans are available based on your state and county. There are specific plans designed for Veterans & Military but they are not common and often hidden.

For questions and guidance on specific programs available to you.

Medicare Advantage Vs. Original Medicare Comparison

To get a better idea of how Medicare Advantage and Original Medicare compare, here is a comparison chart of the different features.

FeatureOriginal MedicareMedicare Advantage
Total Monthly Cost$170.10 In 2022$90 – $170.10 In 2022
Includes Hospital & Doctor CoverageYesYes
Doctor NetworksNo NetworksYes: PPO & HMO Options
Rx IncludedNoOptions With & Without
Dental & VisionNoYes
Hearing AidsNoYes: Often Included
Fitness / Health ClubNoYes

This table provides estimates and a general comparison of Original Medicare & Medicare Advantage. Benefits & costs vary with different plans. Refer to plan specific documents such as the Summary of Benefits. Contact us for details.

Part B Giveback $

Part B Giveback is a rebate that Retired Military, Veterans, and their Families can take advantage of to lower their monthly cost of Medicare.

For questions and guidance on rebates available to you.

Featured Heroes Testimonials & Profiles

About our Veteran & Military clients and what they have to say

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Michael Pauley served in the US Army from 1978 through 1998. He then served in the South Carolina National Guard from 1998 until 2001. After that, he served 20 more years in the US Army Reserve and US Navy. Michael’s most profound memory of his service is flying Dustoff / MEDEVAC. He currently lives in South Carolina and is a retired Lawyer, Soldier, Sailor, and Science Fiction Writer.

In his own words, Michael chose a Medicare Advantage plan with us because; “Having a Medicare Plan that is bundled through same provider and My Tricare, along with the outstanding service, make this a great fit for me.”

Patricia Hill served in the US Army for 21 years and 6 months. Her fondest memory of her service was completing her Rites of Passage. She says was a grueling week but helped her grow and build comradery. She currently lives in Virginia and enjoys gardening, reading, and home decorating.

In her own words; “It was a pleasure working with Lonestar Medicare and Medicare For Heroes. Ben provided quite a bit of information about Medicare/Medicare Advantage Programs. Especially important to me were plans geared towards Military Retirees and Veterans. Ben was also very responsive in answering my questions. Because of all of the information I received, I am confident that I chose the best Medicare Advantage plan to suit my healthcare needs.”

After 25 years of service in the US Air Force, Robert Wood retired as a Lt. Colonel in 2006. After that he worked for a defense contractor and retired from there in 2017. Robert currently lives in Texas where he enjoys supporting his wife who is a local teacher. He also has plenty of time to keep up the house and yard, which he didn’t before. His fondest memory of his service was last assignment with the 100th Air Refueling Wing, RAF Mildenhall, UK. “I enjoyed the people I worked with and worked for. We had great comradery and sense of teamwork to get the air-refueling mission accomplished.”

In his own words; “Starting Medicare, there seemed to be an overwhelming number of options available. I found an advertisement for Lone Star Medicare / Medicare For Heroes and gave them a call. I talked to Ben Rodriguez and he was very knowledgeable and interested in finding the best Medicare coverage for my personal needs. After he asked me several questions about my personal situation, he recommended the Humana Honor (PPO) Medicare Advantage Plan as the best fit for me. I chose this plan because it covers all of my healthcare needs, most of which were in Network for my current doctors. The Humana Honor plan works with Tricare for Life, which pays any additional costs and co-pays that the Humana Honor plan does not cover. I’m very happy with the Humana Honor (PPO) Medicare Advantage Plan and the outstanding service and assistance I received from Ben Rodriguez and Lone Star Medicare.”

Michael & Mona Harness both served in the US Air Force. Michael served for 21 years and Mona 14. They met in Yakota Air Force Base in Japan. Michael’s favorite memory is the wonderful airmen he had the pleasure of serving with. They currently live in Texas. Michael enjoys woodworking and fishing. Mona is enjoying quilting and yard work.

In their own words; Having used military medical all my adult life, I had zero knowledge of civilian medical care and the Medicare program. Medicare For Heroes was able to explain everything to me. I chose the Humana plan they recommended for me and have had nothing but good experiences. From dr visits to the otc program, I highly recommend Humana health care.”

Harry served in the US Coast Guard for 24 years and 8 months. He was stationed at the Great Lakes, Florida, Louisiana, and finally in Port Arthur, Texas, which is where he met his wife Mada. Regarding his service he says; “One of my proudest accomplishments in the military was performing drug interdiction within the passes of Florida, Cuba and Mexico.”

Harry & Mada currently operate a marine surveying business, which Harry says is supported by the leadership skills he gained in the US Coast Guard. They have 6 children, 9 grandchildren, and enjoy traveling in their RV & boat.

In their own words they chose a Medicare Advantage plan through us because; “It has been a pleasure working with Ben Rodriguez with Lone Star and Medicare For Heroes. Entering into the Medicare system can be overwhelming and he was there to help guide us through the multitude of questions we needed answers to. The Humana Honor Health Plan has helped us save over $100 on our premiums. In fact, our co-pays are less than they were with our military insurance.

It is a PPO program, but we found all our primary care physicians and specialists are In-Network Providers. Being retired military, we have Tri-Care as our secondary plan. We haven’t had to change a thing. We are also taking advantage of the OTC pharmacy program for routinely purchased OTC drugs, such as 81 mg aspirin, vitamins and diabetic needs. Plus we have the added advantage of the hearing, dental and vision benefits that Medicare doesn’t include. This plan is adequately able to help even if you’re not real computer savvy. It is just as easy to handle any insurance business over the phone and the personnel are pleasant and willing to make sure all our needs are met.”

Neil Houser served in the US Air Force for 20 years. His best memory is Working Heritage Park at England AFB in Alexandria, LA. He was was the Project Manager, in charge of Assembling all the Real Flying Tiger Aircraft and making them ready to Mount on Pedestals. Neil currently lives with his wife Irene in Texas where he works as an IT / Data Analyst. He enjoys golfing and music, which makes sense that he lives near Austin.

Neil and his wife have Tricare For Life and they chose a Medicare Advantage plan with us. In their own words, this is because; “I’ve been working with Ben Rodriguez and Medicare For Heroes for over a year now. We’ve been bombarded with Mail, Email, Social Media about Medicare and supplements. Ben has gone the extra mile to provide Education, and Support. He extremely knowledgeable and friendly. He is certainly 5 stars!”

Top Medicare Advantage Providers For Military & Veterans

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General Frequently Asked Questions

When will I start Medicare? If you are turning 65, you start Medicare the first day of the month of your birthday. If you are disabled, you typically start Medicare 24 months after you start receiving disability.

What Costs Are Associated With Medicare? Medicare has 2 types of costs; Monthly premiums and medical cost sharing. A premium is the cost you pay to have the coverage, typically monthly or quarterly. Cost sharing is what you pay when you have medical care. If you have secondary insurance such as Tricare, it can cover your medical cost sharing. These are items such as deductibles and copay’s. The standard monthly premium most people pay in 2022 is $170.10. There are ways to lower your monthly premium such as Part B giveback and state programs.

When should I apply for Medicare? First, if you are already receiving Social Security payments when you become eligible for Medicare, you don’t need to apply. You will be automatically enrolled in Medicare. If you are turning 65 and not yet receiving Social Security, you need to apply. You can do so 3 months before the first day of the month that you turn 65.

How do I enroll in Medicare? 1. Apply Online through the Social Security website. 2. Call the Social Security Administration at 1-800-772-1213 and schedule an appointment to enroll by phone. Instead of calling the main Social Security 800 number, you can call your local office to schedule a phone enrollment. To find your local office click here.

What Penalties Can I Incur With Medicare? If you don’t enroll in Medicare Part B when you’re first eligible, and decide to enroll later, your monthly premium will include a penalty. Your penalty gets worse based on the length of time that you didn’t sign up. Penalties can be avoided if you maintain other insurance such as employer group medical. Veterans Administration benefits do not count as other coverage toward penalties.

What is the benefit of working with Lone Star Medicare? Medicare can be confusing and the government doesn’t directly provide you with all benefits. So, you have choices to make and things to do. As a top independent agency, we are a one stop guide and resource to help make your life easier. We can help you get the coverage you need and save money. There are also no fees or costs for you, it’s a win win.

Medicare Advantage Frequently Asked Questions

Will Medicare Advantage and it’s extra benefits cost me more monthly? In most cases no. The nice thing about Medicare Advantage is that you can get extra benefits included, for no extra monthly cost. In fact, in some cases you can get the extra benefits and lower your overall monthly cost (see Part B giveback below.)

What is Part B Giveback? Part B Giveback is a benefit of certain Medicare Advantage plans, and in particular, designed for those with Military or Veterans health benefits. In these cases the plan gives you money back, which lowers your overall monthly cost of Medicare. This could save you hundreds or more dollars per year. Part B giveback doesn’t lower the quality of your coverage.

How does Medicare Advantage provide extra benefits for no extra monthly cost? When you sign up for a Medicare Advantage plan it is provided by a private insurance company and it becomes your Medicare benefits. Medicare then pays your insurance provider a monthly amount to provide you with your benefits. Insurance providers are already efficient at providing extra benefits (dental, vision, hearing, etc), so they’re able to include them for no extra cost.

Will having Medicare Advantage lower the quality of my coverage or care? No. Medicare Advantage is regulated by the federal government. Medicare Advantage plans provide coverage for medically needed care and treatment. However, the quality of service and doctor / hospital networks can vary with different plans and insurers.

If I sign up for Medicare Advantage, can I keep my doctors or will I need to change them? If you have VA benefits, you can continue with your current doctors at VA facilities & network providers. For military hospitals & clinics, as long as they agree, you can continue to use them. This is the same for Standard Medicare. For private / civilian doctors, in most cases, you will be able to keep seeing them. Medicare Advantage plans have networks, meaning a list of doctors and hospitals that are accept the plan. Some Medicare Advantage plans allow you to go out of network, to any doctor. When evaluating a Medicare Advantage plan, you should check if your doctors and medical providers accept the plan. If you’re working with us, this is something that we will do for you.

When can I enroll in a Medicare Advantage plan to get additional benefits? There are two primary periods when you can enroll in a Medicare Advantage plan. 1. When you first start Medicare A & B. 2. During the Annual Open Enrollment period which begins October 15th and lasts through December 7th.

If I decide to take Medicare Advantage instead of Original / Standard Medicare, can I ever change back? Yes. Each year from January 1st through March 31st you can dis-enroll from a Medicare Advantage plan and go back to Original Medicare.

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