TRICARE for Life beneficiaries
are being notified that as of October 1st, military retirees (over age 65) who receive care at a Department of Veterans Affairs facility for non-service connected ailments will be required to pay the VA 80% of the TRICARE allowable charges. By law TRICARE, will only pay up to 20 percent. The remaining 80 percent is equal to the amount that Medicare would have paid if the beneficiary had used a Medicare certified provider.
This is not a new a new Law, it is a regulation that both agencies (TRICARE & VA) recently realized was not properly enforced for over a decade.
To avoid getting charged the remaining 80 percent, TRICARE and the VA are urging that you only seek care for service connected disability at VA health care facilities and seek care for all other medical services at a certified Medicare provider
It is important to note that higher priority veterans will not be impacted by the enforcement of this rule. For example, veterans with VA disability ratings of 10 to 40 percent will continue to receive cost-free VA care for any condition. These veterans are only required to pay a co-payment of $8 on outpatient medications for non-service-connected conditions. Veterans with service-connected ratings of 50 percent or higher are not required to make any co-payments for care at VA facilities.