Turning 65 / Medicare Eligible

Q: I am turning 65 next month. What do I need to do to keep my Johns Hopkins US Family Health Plan coverage?

A: You don’t need to do anything different. As long as you pay your US Family Health Plan annual enrollment fee, your coverage remains in effect. You may want to find out more about enrolling in Medicare.  US Family Health Plan members who are enrolled in Medicare Part A and B do not pay annual enrollment fees or copays for office visits. They pay only DoD TRICARE-designated copays for prescriptions. You don’t have to enroll in Medicare but you should understand all your options and associated costs.

Q: I am over 65 and have TRICARE for Life. Can I enroll?

A: Yes, you can enroll. The Johns Hopkins US Family Health Plan accepts new members over age 65.

Q: Do I lose TRICARE for Life if I enroll in Johns Hopkins US Family Health Plan?

A: You do not lose your eligibility for TRICARE for Life but you will not be covered by TRICARE for Life because you can only be in one TRICARE plan at a time. The Johns Hopkins US Family Health Plan will become your primary coverage and Medicare will be secondary. You remain eligible for TRICARE for Life so long as you remain enrolled in Medicare Part B.    

Q: When I go to my doctor, do I show my Johns Hopkins US Family Health Plan member card or my Medicare card?

A: Only your Johns Hopkins US Family Health Plan member card is needed.  The Johns Hopkins US Family Health Plan is the primary coverage so you don’t need to show your Medicare card. If you have questions about coverage, please call Customer Service at 1-800-808-7437 before you seek medical services.

Q: Which Medicare plan do I need to enroll in to get your Plan?

A: It is not mandatory that you take Medicare to enroll in the Johns Hopkins US Family Health Plan. If you do not enroll in Medicare Part B when you turn 65, and choose to join Part B later, you may be subject to penalties.  (Check the Medicare website for exact information). If you do enroll in Medicare Part A and B, your portion of US Family Health Plan annual enrollment fees as well as office visit copays will be waived and the only copay will be for prescriptions.

Q: Can I keep my doctor? Can I choose any doctor or practice I want?

A: The Johns Hopkins US Family Health Plan is a managed care plan, which means you must choose your primary care doctor from our network of providers.

Q: Do I need to send a copy of my Medicare card to you?

A: No, as long as your information is listed in DEERS that you are enrolled in Medicare.

Q: I am a Plan member who has Medicare Part B. How does Medicare and Johns Hopkins US Family Health Plan work?

A: Once you are a Plan member, you are advised to continue your Medicare Part B to avoid penalties or waiting periods should you choose to leave the Plan and need to use your Medicare benefits. (DoD strongly recommends that you enroll in Medicare Part B when you are first eligible to avoid breaks in TRICARE coverage and Medicare Part B late-enrollment surcharges).

If you are Medicare-eligible and enrolled in the Johns Hopkins US Family Health Plan, your Medicare coverage remains in effect.  However, as a condition of membership, you have agreed not to use Medicare Parts A and B or to enroll in a Medicare-sponsored managed care plan (HMO) such as Medicare Advantage plans while enrolled in the Plan. You are expected to receive all health care services through the Plan.  Using Medicare benefits while a Plan member may result in disenrollment.

You may use Medicare for certain benefits that are not covered by the Plan. Contact Customer Service prior to using Medicare for non-covered benefits to ensure that such use does not compromise your membership in the US Family Health Plan. Retirees with current Medicare Part A and B are not required to pay their portion of the USFHP annual enrollment fees or copays for office visit or facility visits, but will pay pharmacy copays.

It is important to remember:

• Medicare must not be billed for services covered by the Plan
• Members filing Medicare claims or who have claims filed on their behalf are in violation of the conditions of participation for the Plan and may be disenrolled
• Members who have coverage under both the Plan and Medicare may only use Medicare benefits for services not covered by the Plan such as chiropractic care or end-stage renal disease (ESRD)
• For all medical services, Medicare will be billed (as primary) for members with ESRD.

Still have questions?

Johns Hopkins US Family Health Plan Customer Service: 1-800-808-7347
TRICARE: www.tricare.mil
Medicare: www.medicare.gov

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