What to do in this situation?

[My Carmilla]

I have a client case I need to double-check. She's almost 65 (this coming August 20) and has Tricare (survivor benefits) and Medicaid right now. So she's about to age into Medicare soon. From what I understand, it should go Medicare first, then Medicaid, then Tricare for Life picking up the rest. But if Medicaid and Tricare both act as secondaries, is one of them basically redundant here? Just making sure I'm not overlooking some coordination rule.

 

[hlthcr276]

Your understanding of the coordination is exactly correct.
Since it's already August, her Medicare has already become the primary payer as of August 1st.
So the order is now Medicare first, then TRICARE For Life, and finally Medicaid.
TRICARE For Life acts as a great wraparound to Medicare, and Medicaid then serves as the payer of last resort for any remaining costs.
They are not redundant since they work together to give her a very strong safety net and minimize her out-of-pocket expenses!
It actually looks like she's very well-covered which is good!!

 

[pren.up]

I have a client case I need to double-check. She's almost 65 (this coming August 20) and has Tricare (survivor benefits) and Medicaid right now. So she's about to age into Medicare soon. From what I understand, it should go Medicare first, then Medicaid, then Tricare for Life picking up the rest. But if Medicaid and Tricare both act as secondaries, is one of them basically redundant here? Just making sure I'm not overlooking some coordination rule.

Medicare pays first, then Medicaid, and Tricare for Life usually kicks in last to cover what the others don't. In most cases, Medicaid acts as the secondary payer to Medicare, so if Tricare also tries to be secondary, it can get redundant

 

[jordanah;]

I agree so much wth @pren.up Once she enrolls in Medicare at 65, Medicare pays first, then Medicaid covers certain gaps, and Tricare for Life picks up the rest.