FAQ: Getting the Most Out of Medicare
Medicare Open Enrollment begins
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Below, you'll find answers to questions posed by MOAA members during and after the webinar. Click the question to go straight to the answer. Prefer a PDF? Download it here.
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* How is my Medicare Part B premium determined? Is it based on my income? What is IRMAA?
* What is a Medicare Part C: Medicare Advantage Plan (MAP)?
* Do Medicare or TRICARE For Life cover dental and/or vision? Will a Medicare Advantage Plan (MAP) cover dental and vision?
* Do I still have to pay the Part B premium if I sign up for a Medicare Advantage Plan (MAP)?
* Does enrolling in a Medicare Advantage Plan (MAP) Plan change my Medicare and TFL benefits?
* Is a Medicare Advantage Plan (MAP) a supplement to Medicare Parts A and B and TFL? Do I need Medicare Part A and B and a MAP Plan?
* Can you still use a military treatment facility (MTF) with a Medicare Advantage Plan (MAP)?
* How does a Medicare Advantage Plan (MAP) work for provider networks (HMO vs. PPO)? Do I get to choose my doctors with a MAP?
* How does a Medicare Advantage Plan (MAP) work for pre-approvals and prior authorization?
* How much does a Medicare Advantage Plan (MAP) typically cost?
* Do I need to file TRICARE For Life claims myself if I get a Medicare Advantage Plan?
* I plan to work past age 65 and will keep my company's health care. Do I still need to enroll in Medicare at age 65?
* I have
* Does a Medicare Advantage Plan (MAP) impact care received from the
* Can I sign up for a Medicare Advantage Plan (MAP) at any time, or do I have to wait for an open enrollment period?
* If I move to a Medicare Advantage Plan (MAP) and decide I'd like to go back to regular Medicare, am I able to do that?
* Can a member and spouse have different benefits? Do they have to enroll in the same programs?
* Who is
* How do I set up a consultation to review whether a Medicare Advantage Plan (MAP) could be right for me?
* How do I reach someone to talk specifically about GLP-1s?
* How do I participate in the GLP-1 Bridge Program?
* What is Medicare Part D and how does it impact my TRICARE For Life benefits?
* Does TRICARE for Life cover GLP-1s for conditions other than weight loss?
* What is MOAA doing to advocate for TRICARE and TFL to cover GLP-1s?
* Have you heard from MOAA members who have worked with
Q: How is my Medicare Part B premium determined? Is it based on my income? What is IRMAA?
A: Most people pay the standard Medicare Part B premium, which is
If your income is above certain limits, you may pay an additional amount called the Income-Related Monthly Adjustment Amount (IRMAA). IRMAA guidelines can change annually and are different depending on whether you file individually or jointly as a married couple. You can view IRMAA's 2026 income thresholds and costs here. The higher your income, the higher your Part B premium may be.
If your income has significantly decreased since the tax year Medicare is using, especially because of certain life-changing events such as retirement, you have the right to request
No matter how much you pay for Medicare Part B, a Medicare Advantage plan that includes a Part B premium reduction benefit will reduce the amount you pay toward your Part B premium. You can contact MOAA's Medicare Advantage partner,
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Q: What is a Medicare Part C: Medicare Advantage Plan (MAP)?
A: Medicare Part C, also known as Medicare Advantage, is an official part of Medicare created by federal law in 1997. That's why it's also identified by a letter, just like Medicare Parts A,
"A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called 'Part C' or 'MA Plans,' are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, the plan will provide all of your Part A (
Medicare Advantage plan options differ depending on location. MOAA members can contact MOAA's Medicare Advantage partner,
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Q: Do Medicare or TRICARE For Life cover dental and/or vision? Will a Medicare Advantage Plan (MAP) cover dental and vision?
A: Original Medicare and TRICARE For Life generally do not provide any routine dental or vision benefits. Neither covers most routine dental care, eye exams, eyeglasses, or contacts, although certain services may be covered when medically necessary in very limited circumstances.
This is an area where a Medicare Advantage plan can add significant value. According to 2025
These additional benefits can include dental, vision, hearing, and Part B premium reduction benefits, which reduce what you pay for Medicare Part B. Included benefits vary by plan and location, so contacting MOAA's Medicare Advantage partner,
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Q: Do I still have to pay the Part B premium if I sign up for a Medicare Advantage Plan (MAP)?
A: Medicare Advantage plans do not change or remove the Medicare Part A and B coverage to which you're entitled as a federal benefit. Therefore, you must continue paying your Medicare Part B premium to the Federal government when enrolled in a Medicare Advantage plan.
However, the majority of Veteran-focused Medicare Advantage plans — 75% of them, according to recent research — include a Part B premium reduction benefit that pays a portion of your Part B premium, reducing what you have to pay. You'll see this reduction as a credit to your
MOAA members can contact MOAA's Medicare Advantage partner,
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Q: Does enrolling in a Medicare Advantage Plan (MAP) Plan change my Medicare and TFL benefits?
A: No. Enrolling in a Medicare Advantage plan does not remove your Medicare or TRICARE For Life benefits. You retain Medicare Parts A and B and your TRICARE For Life coverage.
The difference is that your Medicare Advantage plan administers your Medicare-covered services instead of Original Medicare, while TRICARE For Life remains in place as secondary, wraparound coverage for all TRICARE-covered services.
It's important to choose a Medicare Advantage plan that works alongside TRICARE For Life. Contact MOAA's Medicare Advantage partner,
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Q: Is a Medicare Advantage Plan (MAP) a supplement to Medicare Parts A and B and TFL? Do I need Medicare Part A and B and a MAP Plan?
A: A Medicare Advantage plan is not a Medicare Supplement. For military retirees with TRICARE For Life, there is generally no reason to enroll in a Medicare Supplement plan, as it would be duplicative coverage that only adds an additional premium.
Medicare Advantage, on the other hand, is another approved way to receive your Medicare Part A and Part B benefits through a private insurance company offering a plan authorized by the Federal government.
Because these plans administer your federal Medicare benefits, you must remain enrolled in both Medicare Parts A and B to enroll in and remain eligible for a Medicare Advantage plan.
MOAA members can learn about the Medicare Advantage plan options available to them by connecting with MOAA's Medicare Advantage partner,
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Q: Can you still use a military treatment facility (MTF) with a Medicare Advantage Plan (MAP)?
A: TRICARE has specific guidelines regarding use of MTFs with a MAP, which are important to be aware of. TRICARE has information available at these locations: Understanding Medicare Part D and TRICARE Pharmacy Coverage and Q&A: How Does TRICARE For Life Work With Medicare?
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Q: How does a Medicare Advantage Plan (MAP) work for provider networks (HMO vs. PPO)? Do I get to choose my doctors with a MAP?
A: Medicare Advantage plans can limit medical provider access, but they certainly don't have to.
A
A
If keeping your current providers is your priority (as it is for most MOAA members),
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Q: How does a Medicare Advantage Plan (MAP) work for pre-approvals and prior authorization?
A: A Medicare prior authorization or pre-approval means a health care provider gets approval from Medicare or an approved insurance carrier using Federal Medicare guidelines before delivering a service or treatment. Beneficiaries don't have to take any additional action, and these requirements apply only to scheduled services — not to emergency or urgently needed care, which are always exempt.
It's important to note that Original Medicare already requires prior authorization for certain major services (like durable medical equipment), and additional requirements took effect in 2026. For Federally approved Medicare carriers, prior authorizations are permitted under Medicare law but only in specific circumstances authorized by Medicare itself. These approved carriers must follow the same rules as Original Medicare — approving all medically necessary services and adhering to Medicare's guidelines in the process.
Prior authorization serves two main purposes — to prevent fraud and to protect beneficiaries. Recent reports estimate that Medicare — and by extension, American taxpayers — loses at least
Both Original Medicare and Medicare Advantage operate under the same Federal standards of medically necessary care, and the evidence from both Government and civilian sources shows that beneficiaries in both programs consistently receive the care they need. Illustrating this, a comprehensive 62-study meta-analysis from the
Prior authorizations help safeguard the Medicare system from fraud, protect vulnerable beneficiaries, and contribute to ensuring taxpayer dollars are used responsibly. MOAA members can contact MOAA's Medicare Advantage partner,
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Q: How much does a Medicare Advantage Plan (MAP) typically cost?
A: Medicare Advantage plans can have additional monthly premiums, and 40% of civilian-focused plans do. Veteran-focused Medicare Advantage plans, on the other hand, overwhelmingly have no premium at all (99%), and most also include a Part B premium reduction benefit (75%). These plans actually reduce what recipients pay for Medicare Part B, all without adding additional premiums.
Included benefits vary by plan and location, so contacting MOAA's Medicare Advantage partner,
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Q: Do I need to file TFL claims myself if I get a Medicare Advantage Plan?
A: No. In most cases, you should not have to file TRICARE For Life claims yourself when enrolled in a Medicare Advantage plan. Your provider should handle everything — billing the Medicare Advantage plan first and TRICARE For Life as secondary for TRICARE-covered services.
As with any health insurance, though, billing errors can occasionally happen. If you ever receive a mistaken bill or claim error, that's where
You'll never pay anything for the support and resources you receive through
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Q: I plan to work past age 65 and will keep my company's health care. Do I still need to enroll in Medicare at age 65?
A: The answer depends on your employer's health plan, the size of your employer, and your personal situation. For specific guidance, contact Medicare directly.
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Q: I have
A: This is what the
"You can save money if you drop your private health insurance, but there are risks. We encourage you to keep your insurance for these reasons: We don't normally provide care for Veterans' family members. So, if you drop your private insurance plan, your family may not have health coverage. We don't know if
Before making any changes to your Medicare coverage, consider contacting MOAA partner
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Q: Does a Medicare Advantage Plan (MAP) impact care received from the
A: No. Enrolling in a Medicare Advantage plan does not remove or reduce your
If you have
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Q: Can I sign up for a Medicare Advantage Plan (MAP) at any time, or do I have to wait for an open enrollment period?
A: There are several opportunities throughout the year to enroll in or change a Medicare Advantage plan. The Annual Enrollment Period (AEP) runs from
There are also many Special Enrollment Periods (SEPs) available throughout the year. Things like moving, a natural disaster, or other qualifying circumstances can give you an opportunity to enroll in or change a plan during the year.
Connecting with
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Q: If I move to a Medicare Advantage Plan (MAP) and decide I'd like to go back to regular Medicare, am I able to do that?
A: Yes. Enrolling in a Medicare Advantage plan does not permanently lock you into Medicare Advantage. If you decide you would rather return to Original Medicare, you can do so during an applicable enrollment period.
Because you remain enrolled in Medicare Parts A and B while you have Medicare Advantage, returning to Original Medicare does not restart your Medicare coverage or cause a Part B late-enrollment penalty.
The Annual Enrollment Period (
MOAA members can contact MOAA's Medicare Advantage partner,
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Q: Can a member and spouse have different benefits? Do they have to enroll in the same programs?
A: Medicare coverage is individual, so spouses do not have to enroll in the same Medicare Advantage plan or make the same Medicare coverage choices. Each person can choose the option that works best for their individual needs.
It's completely normal for one spouse to enroll in a Medicare Advantage plan while the other remains with Original Medicare, or for both spouses to choose different Medicare Advantage plans.
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Q: Who is
A:
As with any brokerage that offers Medicare Advantage Plans,
MOAA maintains an active role in the relationship with VHC to ensure members' needs are being met.
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Q: How do I set up a consultation to review whether a Medicare Advantage Plan (MAP) could be right for me?
A: Many members prefer to start by browsing
MOAA Members can also call
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Q: How do I reach someone to talk specifically about GLP-1s?
A:
Contact
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Q: How do I participate in the GLP-1 Bridge Program?
A: To participate in Medicare's GLP-1 Bridge Program, you must first have qualifying Medicare Part D prescription drug coverage, either through a stand-alone Part D plan or an eligible Medicare Advantage plan that includes Part D. Original Medicare alone, TRICARE For Life, and
You must also meet Medicare's medical eligibility requirements. You can learn more about Medicare's medical requirements here and here.
For military retirees and veterans, adding Medicare Part D does change how existing prescription coverage works, so it's important to understand those tradeoffs before enrolling. For more information, read the next FAQ or consider connecting with
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Q: What is Medicare Part D and how does it impact my TRICARE For Life benefits?
A: Medicare Part D is Medicare's prescription drug coverage. If you choose to enroll in Medicare Part D, the Part D plan generally becomes your primary prescription drug coverage and TRICARE pharmacy coverage pays second for TRICARE-covered medications. This can change your drug formulary and which medications you have access to, the pharmacies you use, how prescriptions are processed, and what coverage rules apply. You'll also lose access to
Importantly, enrolling in Part D does not remove your TRICARE For Life medical benefits. However, because it changes how your prescription coverage works, military retirees should understand all of the tradeoffs before adding Part D.
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Q: Does TRICARE for Life cover GLP-1s for conditions other than weight loss?
A: Find more information on TRICARE For Life's coverage of GLP-1s here, and feel free to contact TRICARE for more information.
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Q: What is MOAA doing to advocate for TRICARE and TFL to cover GLP-1s?
A: MOAA is continuing efforts with Pentagon leadership and elected officials on
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Q: Have you heard from MOAA members who have worked with
A: Yes! Members have shared their feedback. A sampling is provided below.
This was phenomenal. I want to give you that feedback because I was just in the commissary, and I've been talking to other folks that didn't understand
— Sharron M, MOAA Member
I just want to say that I've had the opportunity to talk to one of the agents at great length, and he was really interested in talking to surviving spouses because he said he has learned that they have a lot of questions. There's a lot of misunderstanding about what they're eligible for, etc. And so, we will be setting up a meeting with him to speak to our surviving spouse virtual chapter group. He's mainly just there for informational purposes — he's not going to be trying to sell a product or anything, but to answer questions and provide information to our surviving spouses. He's been a wonderful contact; full of information and absolutely no pressure to do anything at all. So, I highly recommend.
— Gail J., MOAA Member and MOAA Board Member
— Roni & Tally S., MOAA Members
The plan I worked out with you is going great! At my dentist's office, they said it was the best plan they have ever seen.
— Thomas C., MOAA Member
My wife and I are both using
— Don T., MOAA Member, USAF Physician and
I'm writing to express my sincere appreciation for the excellent support provided by our
— Alan R., MOAA Member
MOAA's partner,
— Don B., MOAA Member and Legislative Leader
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