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TIPS & CLIPS

have been receiving numerous phone calls with ques-
We at NERA tions regarding health care coverage, everything from
questions about Medicare Part B, TRICARE, and supplemental spouse’s insurance. Mike
Hughes has pulled together an excellent resource to answer these and other questions.
Hopefully this helps answer your retirement health insurance questions.

By Michael P. Hughes, OSC, USNR (ret), NERA Vice President
Over the last few months we have received many phone calls and emails from our members
in NERA with questions about their health care insurance coverage when they retire with
20 or more years of service. I know from having gone through it personally and researching
it for answers for members that it can be very confusing and daunting. In this writing I will
Joanne Elliott, YNC attempt to cover the highlights of what is available for coverage and an estimate of expected
National President costs of each option.

Plan Options for specialty visits or care that the provider deems necessary.
The option that an individual retiree may choose will ● Premiums for 2021- Individual $297/year;
depend on non-military coverage, eligibility, age, health Family $594/year
status, coverage needed and costs. ● Co-Pays- Primary Visit $20; Specialty Visit $30
● No Deductibles
If you retire prior to age 60 you can purchase TRICARE
Retired Reserve until you reach age 60. At age 60 you TRICARE Select
can purchase either TRICARE Prime or TRICARE Select This is a network provider plan with annual deductibles
until you reach age 65. At 65 years of age you are no lon- and some non-network approved specialty visits allowed
ger eligible for Prime or Select. To continue TRICARE at higher costs.
coverage you must obtain Medicare Parts A and B and ● Premiums: Individual $12.50/month;
TRICARE for Life. Family $25/month
● Deductibles: Individual $150/year; Family $300/year
Following is a general overview of each of the available ● Co-Pays: Primary Visit $29; Specialty Visit $41 (25%
options with some estimated costs. This is not an all- of billed rate for non-network)
inclusive comprehensive accounting, but an attempt to
highlight the major differences between the plans. Please TRICARE for Life
consult your regional TRICARE provider for further info. Once a retiree reaches 65 years of age they are no longer
eligible for any of the aforementioned plans in Tricare. To
TRICARE Retired Reserve maintain Tricare coverage they must apply for and obtain
This is a premium based health insurance program with Medicare Part A & B coverage and TRICARE for Life.
monthly payments and annual deductibles. There are set Medicare is first payer and TRICARE for Life is second-
co-pays for most services with lower costs for network pro- ary payer.
viders versus non-network. Non-network costs are typically Costs: There are no premiums for Tricare for Life, but
25% of billed rates. Costs have usually risen annually. there are monthly premiums based on income for
● Premiums for 2021: Individual $485/month; Medicare Part B, which covers most ambulatory care
Family $1,165/month and provider visits. Medicare Part A covers hospital
● Deductibles: Network -Individual $158/year; care and there are no premiums.
Family No more than $317/year
● Catastrophic Cap: $3,703 Medicare Part A:
Medical and Surgical
TRICARE Prime ● 1 to 60 days of hospital stay: 100% of allowable costs
This is a network provider plan with set fees for primary visit after $1,364 deductible each benefit period.
and specialist visit. All care must be through a network pro- TRICARE for Life pays the $1,374 deductible.
vider and that network provider will approve any referrals You Pay $0.

14 The Mariner • 2020 WINTER Edition • Volume 63 • Issue 3