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Tri-Care picks up the 20% Medicare doesn’t cover

What isn't specified is that Medicare tells the doctor and hospital how much they will be reimbursed and that is the 20% that supplemental insurance will cover. So if your surgery should have cost $5,000 and Medicare says it will only pay $1500 then the hospital will get $1200 (80% of $1500) and the insurance will pay the 20% left over of $300. If the supplemental insurance isn't free it is often cheaper to just pay that 20% yourself.

Since my medical costs are so low, I opted out of supplemental insurance and saved myself $1600 per year of premiums.

What isn't specified is that Medicare tells the doctor and hospital how much they will be reimbursed and that is the 20% that supplemental insurance will cover. So if your surgery should have cost $5,000 and Medicare says it will only pay $1500 then the hospital will get $1200 (80% of $1500) and the insurance will pay the 20% left over of $300. If the supplemental insurance isn't free it is often cheaper to just pay that 20% yourself.

Since my medical costs are so low, I opted out of supplemental insurance and saved myself $1600 per year of premiums.

When one moves from TriCare Prime to Medicare, it becomes TriCare for Life - one pays the Medicare out of their SS, but stops paying for TriCare Prime - that makes our supplemental Insurance "free".

My Prostate Insurance was billed to TriCare at $238K, but TriCare disallowed $200K (Spent 6 hours in surgery and was discharged at noon of second day so it's obvious the hospitals overcharge the insurance knowing that they won't get the asked for amount (one of the evils of how they treat insurers as many will give heavy discounts for those who pay their own bills w/o having insurance).

When my wife sees a doctor that isn't part of the normal TriCare system, Medicare pays the 89% and TriCare picks up the rest - she's had some expensive procedures and the 20% would've added up to about $150K so far and she will likely need a knee replacement soon.

I understand that many will benefit from eschewing supplemental insurance but some of us would be paying hefty fees w/o it. Being retired Military is a big benefit for us.