Disabled veterans returning to civilian life may face many challenges related to healthcare and finances. In such situations, they are likely to come across two crucial programs: Tricare and Social Security Disability Insurance (SSDI). However, it may be difficult to decide which one to opt for.
Tricare and Social Security Disability Insurance are different programs addressing different needs. SSDI provides disability payments, whereas Tricare focuses on medical coverage. It is possible to receive both at the same time.
Keep reading below to find a detailed comparison of SSDI and Tricare.
Comparison of Tricare and SSDI
Social Security and the U.S. Department of Veterans Affairs pay disability benefits to eligible people and their qualified dependents. However, the programs, processes, and criteria for receiving benefits are very different. Each agency must follow its own definition and requirements.
Following is a detailed comparison between Tricare and SSDI to help you decide which program is right for you.
Overview
Tricare covers medical expenses for active-duty military personnel and their families, in addition to certain reservists and veterans. In contrast to the medical benefits provided by Veterans Affairs (VA) or other disability-related benefits such as Medicare for people who receive Social Security Disability Insurance, this is not a defined plan. Instead, Tricare is an umbrella term used for a range of different plans available.
Social Security Disability Insurance (SSDI) is a program that provides financial support to those who have worked in the past and are now unable to do so due to a disabling medical condition. In certain circumstances, Social Security Disability Insurance provides benefits to members of a disabled person’s family who have a history of employment.
To be eligible for Social Security Disability Insurance, you must first satisfy the Social Security Administration’s definition of disability and then pass the work history test.
Benefits
The specifics of what you can expect from TRICARE are dependent on a number of different things.
They have a variety of plans available, but not all participants qualify for each of them. Coverage, whether or not you have co-pays, the amount of those co-pays, and other factors are all subject to change based on your status and the plan that you select.
In addition, several plans give you a great deal of freedom to select the medical facilities and physicians from whom you receive treatment, allowing you to take control of your own medical care.
Qualification
Being a disabled veteran does not automatically make you eligible for TRICARE. However, some veterans on VA disability may be qualified, and obtaining veterans’ disability payments will not disqualify an applicant.
You have the option to apply for or keep your coverage in addition to your veterans’ benefits. In general, the Department of Veterans Affairs encourages veterans to maintain their coverage.
There are typically three ways in which veterans can qualify:
- They are retired from the military, which normally implies that they have served for at least twenty years on active service
- They have been awarded the Medal of Honor or
- They are medically retired and are on either the Temporary Disability Retirement List (TDRL) or the Permanent Disability Retirement List (PDRL)
TRICARE is especially helpful for disabled veterans with a VA rating below fifty percent because the medical care that they receive from the VA becomes more restricted. Nonetheless, maintaining coverage is a good decision, regardless of your rating.
One major reason is that members of the family who would not be eligible for benefits under the veterans’ program are frequently eligible for coverage via the TRICARE program.
On the other hand, eligibility for the Social Security Disability Insurance program is based on the applicant’s work history. To qualify for Social Security benefits, you must have worked for a specified amount of time in “covered” employment, which refers to jobs or self-employment through which you paid Social Security taxes.
In addition to that, you must fulfill SSDI’s medical criteria, which require that your condition be severe and prevent you from working for a period of at least 12 months.
Which One Should You Get?
As noted above, Tricare is a medical insurance program, whereas SSDI provides disability benefits; thus, they both address different needs and can be received in conjunction. This is how they both work together:
Beneficiaries receiving SSDI are automatically enrolled in Medicare Parts A and B after two years since their benefits started, irrespective of their age. Medicare is a federal health insurance program associated with SSDI.
It is intended for individuals who are aged 65 or older, under 65 with a disability, have end-stage renal disease, or have ALS (or Lou Gehrig’s disease).
Medicare is available in a variety of plans, including:
- Medicare Part A provides hospital coverage. There are no premiums for this plan.
- Medicare Part B program provides medical coverage. Beneficiaries are required to pay monthly premiums.
If you are qualified for Medicare Part A and also have TRICARE, you are required to obtain coverage under Medicare Part B to maintain your eligibility for TRICARE.
The Social Security Administration will notify you when your Medicare coverage begins. When your disability claim and Medicare eligibility are provided retroactively, you need to be sure that the effective dates of your Medicare Part A and Part B are the same.
If the dates on which you were covered by Medicare Part A and Part B are different, Tricare will seek reimbursement for any claims that were paid while you were only covered by Part A.
If an individual is covered by both Medicare and Tricare, Medicare will pay for treatments first, and Tricare will work as supplemental insurance, paying for any costs that Medicare does not cover.
Conclusion
Navigating civilian life as a disabled veteran can be difficult after years of service. Fortunately, there are safeguards in place to help ensure that you do not face challenges in terms of finances or healthcare. Tricare and SSDI are just two of the important programs that you can apply for.
