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Tricare Help: Would Tricare cover wife's long-term care?

Jun. 8, 2012 - 05:14PM   |   Last Updated: Jun. 8, 2012 - 05:14PM  |  
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Q. I retired from the Army in 1975 and I have Tricare for Life. My wife of 52 years passed away in 2010 and now I am thinking of getting remarried. I am concerned about how to protect my children's inheritance if my new wife has to go to a nursing home for a long period of time. What benefits does Tricare offer?

A. Like Medicare, Tricare makes no provisions for long-term care such as in a nursing home.

While there is no upper age limit for active medical care designed to make a patient "well" and able to live more or less independently, Tricare cannot cover long-term care in a protected and secure environment with assistance with the activities of daily living, such as eating, dressing and bathing. That is called custodial care. Both Tricare and Medicare are specifically forbidden by federal law to cover that kind of care.

As a result, you must look to the private sector for such benefits.

Q. I am writing for my father, a retired World War II vet. He wants to know whether Tricare for Life will pay for glasses since he has macular degeneration. Would he be covered?

A. Tricare's benefits are determined by federal law, which specifically excludes eyeglasses and contact lenses from its benefit, with one exception: One pair of spectacles will be covered following cataract surgery to remove the eye's natural lens and the placement of an approved artificial lens.

Q. You have said that retired reservists can begin receiving Tricare benefits at age 60. When I retired, I was informed that the health benefits are free when you are eligible for Medicare at age 65. Which is correct?

A. Both statements are correct; you're talking about two different things. When retirement-qualified reservists reach age 60, they become eligible for military health care benefits in the form of Tricare Prime or Tricare Standard.

Tricare Prime charges an annual enrollment fee of $230 for an individual and $460 for a family for those enrolled before Oct. 1, 2011, and $260 for an individual and $520 for families for those enrolled after that date. Prime has no annual deductibles.

Tricare Standard does not charge an annual enrollment fee, but retirees must pay annual deductibles of $150 for an individual and $300 for a family.

When retirees reach age 65 and become eligible for Medicare, they transition to the program known as Tricare for Life. TFL charges no enrollment fees or deductibles, but the program does require retirees to have Medicare Part B, which carries a premium of about $100 a month.

Under all Tricare programs, retirees also pay some out-of-pocket costs for prescription drugs.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com?subject=Tricare%20Help:%20Would%20Tricare%20cover%20wife's%20long-term%20care?">click here and email us. In email, include the word "Tricare" in the subject line and do not attach files. Get Tricare advice anytime http://www.militarytimes.com/tricarehelp">on our blog.

Answers by RallyPoint

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