Medicare and TRICARE For Life – What Military Retirees Need to Know

If you're a military retiree or a TRICARE-eligible family member turning 65, here's the one rule that matters most:

To keep TRICARE, you need Medicare Part A and Part B.

Once you have both, you get TRICARE For Life automatically. No enrollment form. No separate card. But skip Part B, and you can lose your TRICARE coverage.

Let's walk through how it works.

The mental model: Medicare goes first, TRICARE cleans up

With TRICARE For Life, Medicare is your main coverage. TRICARE For Life is the second payer.

For care that both cover, Medicare pays its share first. Then TRICARE For Life pays the remaining costs it covers, like Medicare's deductibles and coinsurance. That's why many folks with both see small bills for Medicare-covered care.

So the setup is simple: Medicare first, TRICARE second.

The analogy: the wingman

TRICARE For Life is your wingman.

Medicare flies lead. It takes the first pass at every claim. TRICARE For Life flies right behind, covering what Medicare leaves open.

But a wingman can't fly without a lead. No Medicare Part B, no lead plane. And no TRICARE For Life.

Step 1: Sign up for Part A and Part B on time

Your Medicare Initial Enrollment Period is the 7 months around your 65th birthday. That's 3 months before, your birthday month, and 3 months after.

TRICARE For Life starts on the first day you have both Part A and Part B. So timing your Part B right keeps your coverage from having a gap.

If you're already getting Social Security benefits, you'll usually be enrolled in Parts A and B automatically. If not, you sign up through Social Security. My article on how to sign up for Medicare covers the steps.

TRICARE's warning, in its own words: you'll lose TRICARE coverage if you don't have Part B, drop Part B, or don't pay your Part B premiums. That applies even if you live overseas.

One exception: active duty service members and active duty family members with Medicare follow different rules. If that's you, check with TRICARE directly.

Step 2: Keep DEERS up to date

TRICARE checks your eligibility through DEERS, the Defense Enrollment Eligibility Reporting System. TRICARE says keeping your DEERS info current is key to getting your benefits on time.

Moved? Married? New address? Update DEERS.

How claims work

In most cases, you don't file anything.

Your provider bills Medicare. Medicare pays its part and sends the claim on to TRICARE For Life automatically. TRICARE pays its share.

There are a few twists:

• Covered by TRICARE but not Medicare? TRICARE pays first. You pay the TRICARE deductible and cost-shares. Care overseas is a common example.
• Covered by Medicare but not TRICARE? Medicare pays, TRICARE pays nothing. You pay Medicare's share.
• Covered by neither? You pay the full bill.
• Military hospital or other federal provider? TRICARE pays. Medicare usually doesn't pay federal providers.

You can use any provider that takes Medicare. Your proof of coverage is your Medicare card plus your uniformed services ID.

Do I need Medicare Part D?

Usually not. TRICARE For Life includes drug coverage through the TRICARE Pharmacy Program. TRICARE says you don't need Part D to have drug coverage.

But TRICARE also says some folks may benefit from a Part D plan. A Part D plan might cover a drug TRICARE doesn't. If you take something unusual, it's worth comparing. Our Medicare plan finder can estimate Part D costs with your drug list.

Do I need a Supplement or Medicare Advantage?

Neither is required for TRICARE For Life. TRICARE notes that Part C (Medicare Advantage) and Part D aren't required.

TRICARE For Life already picks up most of Medicare's cost-sharing for covered care. So think hard before paying for a supplement on top of it. Some still look at Medicare Advantage for extras. If you do, know that if you have other health insurance on top, claims can get more complicated. Let's talk it through before adding anything.

What about my spouse?

This is the question I hear most.

TRICARE For Life is an individual benefit. When you turn 65 and move to TRICARE For Life, your coverage doesn't extend to your family.

If your spouse is younger than 65, they generally stay on their current TRICARE plan. That lasts until they turn 65 and get Part A and Part B themselves.

So plan two timelines, not one.

Things I'd do (and never do)

1. I'd sign up for Part B so it starts the month I turn 65. No gap in TRICARE.
2. I'd set up automatic payment for my Part B premium. Missed payments can cost you TRICARE.
3. I'd update DEERS after any big life change.
4. I'd put my spouse's 65th birthday on the calendar and plan their move separately.
5. I'd never drop Part B to save money. Dropping Part B can mean losing TRICARE.

Turning 65 with TRICARE?

We'll help you time Part B, check whether Part D makes sense for your drugs, and plan your spouse's switch. Simple and straight.

Call (417) 633-7200. Stop by our Belton office, our Topeka office, or our Springfield office.

Thank you for your service. Let's keep your wingman flying.

— Matt

Frequently asked questions

Do I need Medicare Part B to keep TRICARE?

Yes, if you're entitled to premium-free Part A. TRICARE says you must have Part B to keep TRICARE coverage. Without it, you lose TRICARE.

Do I need to enroll in TRICARE For Life?

No. Once you have both Medicare Part A and Part B, you're automatically covered by TRICARE For Life. There's no enrollment form or fee.

Who pays first, Medicare or TRICARE For Life?

For care both cover, Medicare pays first and TRICARE For Life pays second. For care only TRICARE covers, TRICARE pays first.

Do I need Part D if I have TRICARE For Life?

Usually not. TRICARE For Life includes drug coverage through the TRICARE Pharmacy Program. Some people still compare Part D plans if a drug isn't covered by TRICARE.

Does TRICARE For Life cover my spouse?

No. It's individual. A spouse under 65 generally stays on their current TRICARE plan until they become eligible for Medicare Part A and Part B.