No enrollment is required. Seniors also might face a surcharge, or penalty, of 10 percent for each year they delayed past age 65 to enroll in Part B. Exempt from the surcharge are persons who were covered by employee health insurance instead of Medicare. For 25,000 elderly beneficiaries living overseas, the arrival of Oct. 1 means they can begin using Tricare Standard as their primary medical insurance. They, too, must be enrolled in Medicare Part B, even though the Medicare program isn't available overseas. But the law also requires that the elderly have an equal shot, with under-65 beneficiaries, to enroll in Tricare Prime, the military's managed care program.
Officials expect to comply with that more complex requirement sometime next year.
In the meantime, elderly beneficiaries already enrolled in military managed care programs will be able to stay in them after Oct. 1, said J. Jarrett Clinton, acting assistant secretary of defense for health affairs. This beneficiary group includes 33,500 enrollees in a Tricare Senior Prime demonstration program who likely will become the first elderly population enrolled in Tricare Prime. Also, beneficiaries now enrolled in Tricare Prime can now stay in the program as they turn 65. Indeed, Clinton cautioned hospital commanders and Tricare managers about the higher costs and greater time needed to care for the elderly, suggesting the right age mix of enrolled beneficiaries will have to be determined locally, based on readiness and available resources. Comfortable with their civilian providers, most will elect to use Tricare as second payer to Medicare.