Tricare for Life: The usual one vs US Family Health Plan version

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maxq
Posts: 118
Joined: Thu Sep 25, 2014 3:19 pm

Tricare for Life: The usual one vs US Family Health Plan version

Post by maxq »

Tricare for Life is a great benefit for military retirees who hit 65. As I understand it, Medicare is the primary payer, then Tricare for Life picks up any remaining balance (within program limits that seem pretty generous). In a few regions of the country, Tricare for Life offers the USFHP option. With USFHP, you pick a PCP and need referrals from the PCP to specialists, etc. It also has annual eye exam coverage and things like transportation costs for doctor appointments, and (I think) $50K lifetime coverage overseas. With USFHP, it is the primary payer and Medicare is the secondary. Drug coverage and co-pays seem the same as for the normal TFL, but the pharmacy choice is much more limited. If you move out of your USFHP region, you have to revert to the normal Tricare for Life. USFHP does limit over-65 enrollment, such as having had to be a member before a certain year to continue coverage past 65. Neither TFL or USFHP currently have premiums or deductibles.

I'm in Houston, one of the USFHP regions. Here, USFHP goes through Houston Methodist, one of the largest hospital and doctor networks in the area. As such, as long as I don't move too far, I have plenty of hospitals, clinics, and specialists to utilize. Having been with USFHP for over 10 years, with just routine and minor medical needs, I'm starting to wonder if the normal TFL would be better as I age and perhaps need more medical care. I believe my long-time PCP and the Houston Methodist Hospital network also accept TFL/Medicare, but I'd verify before making any changes. I also have full access to the VA system as a fallback, but for various reasons prefer not to rely on the VA for total care (I do utilize the VA for eye exams, glasses, and service-connected hearing loss).

I can't find much comparative info between TFL and the USFHP version on other websites and forums, so thought I'd ask here if anyone has any insights, experience, or recommendations.
:beer
Rex66
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Joined: Tue Aug 04, 2020 5:13 pm

Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by Rex66 »

Don’t do it

Read the Medicare advantage tricare thread from a few days back
Tooth
Posts: 150
Joined: Sun Mar 28, 2021 3:41 am

Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by Tooth »

Advantage plans seem like shiny packed offers; I'd stick with Medicare and Tricare for life. I'm not Medicare eligible but I have family that asked for opinion. Researched in detail and also have a medical background. Overall feel traditional Medicare especially with Tricare for life offers better value. I feel these other offerings are going to be used to cut benefits and convince people otherwise in the future.
Dontridetheindexdown
Posts: 369
Joined: Sat Feb 14, 2015 9:08 pm

Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by Dontridetheindexdown »

No combination of health insurance beats traditional Medicare combined with Tricare for Life.

The Houston Methodist system accepts traditional Medicare, so you will have no co-pays and no deductibles if you have Medicare and Tricare for Life.

Traditional Medicare allows you the most flexibility, no referrals are required.

I am not at all sure why anyone with Tricare for Life would choose anything other than traditional Medicare.
Lalamimi
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Joined: Mon Jun 24, 2019 4:22 pm
Location: Texas

Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by Lalamimi »

My mother had TFL - she had delayed signing up for Part B , had used DOD before my dad died. It kicked in when she enrolled in Part B - she was not aware she was eligible. (my dad had been medically retired in 1953 from injury in Korea, but she had also been in the Navy). It was wonderful. ongoing meds thru either the VA (she went to the VA clinic in Katy and regular doctors) or ExpressScript, all were free except for one, that was $20. She was in Austin and later Katy, and I really appreciated. Or meds thru HEB or Walmart, almost always free, for Dr. appts. She was admitted to both Methodist West and Memorial Herman numerous times (COPD) and never paid a dime. Medicare covers one eye exam a year, and one pair of glasses after cataract surgery. Stick with TFL!
Topic Author
maxq
Posts: 118
Joined: Thu Sep 25, 2014 3:19 pm

Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by maxq »

Rex66 wrote: Sat Oct 23, 2021 11:57 am Don’t do it

Read the Medicare advantage tricare thread from a few days back
That thread was extremely informative and is what led me to re-think USFHP. USFHP seems to be a lot like Advantage plans in many ways, although it is in fact part of the official Gov't TRICARE program--administered by TRICARE, no underwriting required, etc. Researching the history, it appears USFHP was originally a test program to provide lifetime coverage for military retirees and was one of the first TRICARE programs to provide coverage post-65. TFL came along later, and probably obviated the need for USFHP in that regard.
Rex66
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Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by Rex66 »

Yes it’s the equivalent of an advantage plan

Really Medicare with TCL is best
lgerla
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Joined: Tue Jan 31, 2017 9:07 pm

Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by lgerla »

As you said, this program is closed to new Medicare-eligible enrollments as of 2012.

It seems you would be able to switch to traditional Medicare/TFL, but you can't go back to USFHP if you change your mind again. Also, if you didn't enroll in Part B, you may have to pay a late enrollment penalty to switch.

https://www.tricare.mil/Plans/HealthPla ... P/Medicare

With good access in your area and a PCP you are happy with, you'd have to decide if a new monthly expense (if any) to switch was worth it.
chalet
Posts: 235
Joined: Wed Aug 28, 2019 9:59 pm

Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by chalet »

I missed the part where USFHP was better for something.
Topic Author
maxq
Posts: 118
Joined: Thu Sep 25, 2014 3:19 pm

Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by maxq »

Dontride, thanks for the confirmation that Houston Methodist accepts Medicare.

Good point by Igerla that if I drop USFHP, I can't go back to it later. However at this time, I don't see any advantage for me it has over the 'normal' TFL with Medicare. I have found some anecdotal posts elsewhere that people with USFHP have occasionally had problems getting urgent care clinics outside their region to accept USFHP. The only benefit I see now is for the brave (or insert your own term) person who is willing to take a chance on USFHP as their only medical coverage. If willing to take that risk, they can pass on enrolling in Medicare and the related costs. I see though that even USFHP's fact sheets recommend against this. I've had Part B since hitting 65 so no late enrollment penalty at play here.

FWIW, the USFHP here in south Texas has a clunky and pretty much useless website. However, their phone service is outstanding and its always easy to get a real person on the line in a minute or so.

Unless I'm missing something obvious, I'll plan to change to the traditional TFL during open season later this year. :)
Rex66
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Re: Tricare for Life: The usual one vs US Family Health Plan version

Post by Rex66 »

Your going to find it’s the same with typical advantage complaints. Mostly antidotes here and there. There are people on this site very happy with their advantage or advantage like plans. They haven’t had one of the issues mentioned in the multiple threads. Some of them even understand the differences but feel they have planned appropriately. Great for them. I wouldn’t take the chance that my plans might change.
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