Turning 65: You Have an Important Decision to Make.

As a member of the US Family Health Plan about to turn 65, there are some important things you need to know about your health care coverage. We are here to help you navigate them.

Can I continue as a US Family Health Plan member when I turn 65?

It depends on when you enrolled in the US Family Health Plan.

If you enrolled in the US Family Health Plan at Martin’s Point on or after October 1, 2012 (Non-Grandfathered Status), you will be disenrolled from the US Family Health Plan. Your disenrollment will be effective on the last day of the month prior to the month you turn 65. TRICARE For Life (TFL) will be your TRICARE^® option. You must enroll in Medicare Part B to maintain your TRICARE eligibility. To be covered by TFL, you must enroll in Medicare Part A and Part B (Original Medicare). 

If you enrolled in the US Family Health Plan at Martin’s Point before October 1, 2012 (Grandfathered Status), you have the option of staying enrolled with the US Family Health Plan or disenrolling and using TRICARE For Life (TFL).

If you are unsure whether you are grandfathered or non-grandfathered, please contact your local Health Benefits Specialist from the list below.

Do I need to enroll in Medicare Part B?

If you are continuing your membership with the US Family Health Plan, you are not required to enroll in Medicare Part B. However, we strongly recommend you consider enrolling in Medicare Part B as soon as you are eligible for the following reasons:

1. Delay in Accessing Medicare Part B and TRICARE Benefits: If you ever do disenroll from the US Family Health Plan, you will not be able to access other TRICARE benefits until you are enrolled in Medicare Part B. You will only be able to enroll in Medicare Part B during the General Enrollment Period (January through March each year), with coverage starting on July 1 of the year you sign up. You could be left without medical insurance coverage for an extended period of time should you decide to disenroll from the US Family Health Plan at a later date.
   
   
2. Penalty in Medicare Part B Premiums: If you wait to enroll until after you’re first eligible, your Medicare Part B premium will increase by 10% for each 12-month period that you were originally eligible to enroll.
   
   
3. Limited Coverage for Long-Term-Care Facility: Long- term-care facility residents are not eligible for the US Family Health Plan in most cases. Without Medicare Part B, your coverage will be limited to Medicare Part A and you will be responsible for the costs of medical services provided by physicians, labs, etc.

How do the US Family Health Plan and TRICARE for Life (TFL) compare?