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DBQprep | Getting out

Retired With a Day Job: Two Plans, One Wallet

Not clinic-reviewed.

Retired With a Day Job: Two Plans, One Wallet

TLDR

  • With a civilian employer's plan, the job's insurance pays FIRST and TRICARE pays second — by law — with four named exceptions where TRICARE pays first.
  • Nobody makes you take the job's plan: a retiree can use TRICARE alone, and if the other insurance goes away, TRICARE becomes primary.
  • The federal version has a trap with a body count: Federal Employees Health Benefits (FEHB) eligibility never disqualifies a retiree from TRICARE — but if you're an FEHB annuitant who wants TRICARE instead, SUSPEND FEHB, never cancel it: cancellation is generally permanent.

Who pays first

Under coordination of benefits rules, employer or private other health insurance (OHI) pays first, and TRICARE pays after.

There are four specific exceptions where TRICARE pays first:

  • Medicaid.
  • TRICARE supplemental plans.
  • State victims-of-crime compensation programs.
  • Specified federal programs identified by the Defense Health Agency (DHA), including the Indian Health Service.

If your OHI is lost, TRICARE becomes primary, subject to Medicare and TRICARE For Life coordination.

You don't have to take the job's plan

No rule requires a retiree to carry employer coverage. You may use TRICARE alone, subject to ordinary eligibility and enrollment rules.

The federal job does not break your TRICARE

A retiree who becomes FEHB-eligible through federal employment remains eligible for regular retiree TRICARE. The rule stating FEHB eligibility disqualifies you applies to purchasers of TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR) only — it does not touch regular retiree TRICARE.

You may carry both FEHB and TRICARE at the same time. TRICARE generally processes after FEHB.

First question: annuitant or employee?

You must determine which channel you are in: annuitant or employee.

An annuitant is drawing the federal annuity; their enrollment sits in the Office of Personnel Management (OPM) channel.

An employee is currently working federally; their enrollment is an employee enrollment that sits with the employing agency. A reemployed annuitant's enrollment transfers to the employing agency. Employee Qualifying Life Event (QLE) and premium-conversion rules govern changes for employees, and military-service QLE rules can permit termination or change. The annuitant suspend and cancel process does not apply to employees.

Annuitants: suspend, don't cancel

In the annuitant channel, an FEHB annuitant may suspend FEHB to use TRICARE, TRICARE For Life (TFL), or the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) rather than cancel. Suspension preserves your re-enrollment rights. After suspension, Open Season permits re-enrollment. An involuntary loss of TRICARE or CHAMPVA opens an immediate re-enrollment window running from 31 days before through 60 days after the loss.

For an annuitant, cancellation is generally permanent. Cancellation gives no temporary continuation of coverage and no 31-day extension.

The mechanics run through the OPM channel: file form RI 79-9 plus proof of TRICARE or TFL eligibility. Proof includes a Uniformed Services identification (ID) card, and if you are over 65, a Medicare card showing Parts A and B.

Employees: your different levers

If you hold an employee enrollment, your changes run through your employing agency under employee rules, not through RI 79-9.

If an employee enters active military service over 30 days, they may continue FEHB for up to 24 months or terminate it before entering duty. After service, reinstatement and election rules depend on whether the employee exercises reemployment rights.

The 65 trap

TRICARE For Life requires Medicare Parts A and B. Delaying Part B while covered by employer insurance means you have no TRICARE For Life during that gap. This does not mean you have no TRICARE at all, as other TRICARE coverage may exist depending on circumstances.

When you have Medicare, TFL, and employer coverage together, TFL pays last. The order between Medicare and employer coverage depends on current-employment status and employer size under Medicare coordination rules.

The traps

  • Paying for an employer plan without knowing that employer insurance pays first and TRICARE pays second.
  • Believing FEHB eligibility kills regular retiree TRICARE — that exclusion applies strictly to TRS and TRR purchasers, not to regular retirees.
  • Cancelling FEHB as an annuitant instead of suspending it — cancellation is generally permanent, with no temporary continuation and no 31-day extension.
  • Missing the annuitant re-enrollment windows: Open Season for voluntary return, or the window from 31 days before through 60 days after an involuntary loss of TRICARE or CHAMPVA.
  • Attempting to file form RI 79-9 as a current employee — that process belongs strictly to the annuitant channel.
  • Failing to know the employee active duty rule: an employee entering active military service over 30 days may continue FEHB up to 24 months or terminate it before duty.
  • Delaying Medicare Part B while on employer coverage and assuming TRICARE For Life covers the gap — TFL requires both Parts A and B.
  • Losing employer insurance and failing to inform TRICARE to flip coverage to primary.

Where to go

  • The TRICARE contractor — coordination of benefits and OHI filing.
  • Your employer's human resources (HR) or benefits office — employee FEHB changes, employee QLEs, and active-duty continuation choices.
  • OPM — annuitant suspension via form RI 79-9 and annuitant re-enrollment.
  • BENEFEDS — dental and vision enrollment questions.