Paul Sanchez
TRICARE is a healthcare program that serves uniformed service members, retirees, and their families worldwide. Medicare is a federal health insurance program for US citizens aged 65 and older, or those under 65 with certain disabilities or specific diseases. Individuals with TRICARE who become eligible for Medicare and obtain Medicare Part A must also have Medicare Part B to maintain their TRICARE eligibility. TRICARE for Life is a Medicare wraparound coverage option for TRICARE-eligible beneficiaries with Medicare Parts A and B, providing additional health benefits and reducing out-of-pocket costs. While Medicare typically pays first for services, TRICARE for Life will cover any remaining costs, enhancing the overall healthcare coverage for those who have served in the US military and their families.
| Characteristics | Values |
|---|---|
| What is Tricare? | A health care program that serves uniformed service members, retirees and their families worldwide |
| What is Medicare? | A federal health insurance program for people who are age 65 or older, people under age 65 with certain disabilities, people of any age with end-stage renal disease, ALS (Lou Gehrig's disease), or mesothelioma |
| Who is eligible for Tricare? | Uniformed service members, retirees and their families |
| Who is eligible for Medicare? | US citizens age 65 and older, under age 65 with certain disabilities and those who have end-stage renal disease |
| How do Tricare and Medicare work together? | You can be eligible for both Tricare and Medicare. When you become eligible for Medicare at 65, you need to get Medicare to remain eligible for Tricare. You must have Medicare Part A and B to be eligible for Tricare |
| Do you need Medicare Part D to keep Tricare? | No, you do not need Medicare Part D to keep Tricare |
| Is there an enrollment fee for Tricare for Life? | No, there is no fee for enrolling in Tricare for Life |
| How does Tricare for Life work? | Tricare for Life is wraparound coverage that acts like a supplemental plan. It enhances your existing benefits by reducing or eliminating out-of-pocket costs for treatments and may pay for certain services not covered under Medicare, such as healthcare coverage outside the US |
| Does Tricare for Life cover prescription drugs? | Yes, Tricare for Life includes a prescription drug benefit. However, it may not cover drugs from your preferred retail pharmacy or prescriptions from a non-Veteran's Administration (VA) doctor |
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What You'll Learn
TRICARE for Life is Medicare wraparound coverage for those with Medicare Parts A and B
TRICARE is a healthcare program that serves uniformed service members, retirees, and their families worldwide. Medicare is a federal healthcare program for US citizens aged 65 and older, or those under 65 with certain disabilities or end-stage renal disease.
An individual with TRICARE becomes eligible for Medicare at 65 and must enroll in Medicare to remain eligible for TRICARE. TRICARE For Life (TFL) is Medicare-wraparound coverage for those who are TRICARE-eligible and have Medicare Parts A and B. Coverage is automatic if you have both Parts A and B and pay your Part B premiums. There is no enrollment fee for TFL, and it is available worldwide.
TFL is secondary coverage after Medicare in the US and its territories. In other overseas locations, TFL is the primary payer. TFL may work with Original Medicare (Parts A and B), a Medicare Advantage plan, or a Part D prescription drug plan. However, TFL includes a prescription drug benefit, so enrollees may not need Part D. If you decide to enroll in Part D coverage, you can do so at any time.
When using TFL in all overseas locations, TRICARE is the primary payer, and you are responsible for paying TRICARE's annual deductible and cost shares. You must have Part B to remain eligible for TRICARE even though Medicare does not provide coverage overseas. You must pay Medicare Part A and Part B monthly premiums.
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Medicare and TRICARE eligibility requirements
Medicare is a federal health insurance program for people aged 65 or older, people under 65 with certain disabilities, and people of any age with end-stage renal disease, ALS (Lou Gehrig's disease), or mesothelioma. Signing up for Medicare benefits before turning 65 is essential to avoid a break in coverage. Those eligible for both TRICARE and Medicare Part A typically must also enrol in Medicare Part B to maintain their TRICARE eligibility.
TRICARE is a health care program for military members, veterans, and their families. It offers comprehensive coverage, including prescription drug benefits, which are considered creditable. TRICARE beneficiaries who become eligible for Medicare at 65 can maintain their TRICARE eligibility by enrolling in Medicare Parts A and B. TRICARE For Life (TFL) is an option for those with Medicare Parts A and B, providing additional coverage with minimal out-of-pocket expenses.
For those living or travelling overseas, TRICARE becomes the primary payer, and enrollees are responsible for paying TRICARE's annual deductible and cost shares. While Medicare does not cover overseas locations, TRICARE fills this gap, ensuring continuous care for its beneficiaries. It's important to note that Medicare Part B is still required to maintain eligibility for TRICARE and TFL, even when abroad.
To summarise, eligibility for TRICARE and Medicare is based on specific criteria. TRICARE serves military-affiliated individuals and their families, while Medicare is available for those 65 and older or with certain medical conditions. Maintaining eligibility may require enrolling in both Medicare Parts A and B, especially when utilising TRICARE For Life. For those with unique circumstances, such as overseas residence, TRICARE provides continued coverage, emphasising the importance of understanding the interplay between these two programs.
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Medicare and TRICARE enrollment
TRICARE is a healthcare programme that serves uniformed service members, retirees, and their families worldwide. Medicare is a federal health insurance programme for US citizens aged 65 and older, under 65 with certain disabilities, and those with end-stage renal disease. It is possible to be eligible for both TRICARE and Medicare.
TRICARE For Life is Medicare wraparound coverage for TRICARE-eligible beneficiaries who have Medicare Parts A and B. Coverage is automatic if you have Parts A and B and pay your Part B premiums. There is no fee for enrolling in TRICARE For Life, and it is available worldwide. TRICARE For Life may work with Original Medicare (Parts A and B), a Medicare Advantage plan, or a Part D prescription drug plan.
If you are eligible for both TRICARE and Medicare Part A, you must also have Medicare Part B to keep TRICARE. However, Part D is not required to maintain eligibility. You can remain eligible for TRICARE without enrolling in Medicare Part B only if you are enrolled in TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult, or the US Family Health Plan.
If you didn't sign up for Medicare Part B when you first became eligible, you can sign up during Medicare's general enrollment period (January 1 - March 31 each year). Your Part B and TRICARE For Life coverage will start the first day of the month after you sign up. You may have to pay a Medicare Part B Late Enrollment Penalty. If you are receiving Social Security Disability payments, you will automatically get Medicare Part A and Part B in the 25th month of disability.
Medicare Part D Open Enrollment is from October 15 through December 7 each year. If you want to enrol in Medicare Part D outside of the open enrollment period, you will need to enrol through a Special Enrollment Period.
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TRICARE for Life and Medicare Advantage
TRICARE for Life (TFL) is a health insurance supplement that pays most of the out-of-pocket costs associated with Original Medicare. It is not a Medicare Advantage plan. Instead, it is secondary insurance to Medicare for active-duty and ex-military members.
TFL is available to eligible people across the United States and its territories, including Puerto Rico and Guam. To be eligible for TFL, a person must be an Original Medicare enrollee (Parts A and B) and have military credentials, such as being a retired service member, a surviving spouse, or one of their dependents.
Medicare is the primary payer, and TFL is the second payer. When a person with TFL visits a doctor, the doctor's office files the claim with Medicare. After Medicare processes the claim and pays its portion, the bill goes to TFL, which often pays the remaining costs. People with TFL do not pay a monthly premium but must pay the Medicare Part B monthly premium.
TRICARE also offers the Overseas Program (TOP) for those living in non-U.S. territories with established military hospitals. Because Medicare is unavailable overseas, the TOP program functions as the primary insurer. People with the TOP plan must pay TRICARE's yearly deductible and cost-sharing, as well as any fees that exceed the plan's allowable charges.
Medicare Advantage (Part C) is an alternative to Original Medicare and is offered by private companies. It is a primary health plan that may include prescription drug coverage and other benefits such as dental and vision care.
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Medicare and TRICARE costs
TRICARE is a healthcare program that serves uniformed service members, retirees, and their families worldwide. Medicare, on the other hand, is a federal healthcare program for US citizens aged 65 and older, or those under 65 with certain disabilities or end-stage renal disease. It is possible to be eligible for both TRICARE and Medicare.
TRICARE for Life (TFL) is Medicare-wraparound coverage for TRICARE-eligible beneficiaries who have Medicare Parts A and B. Coverage is automatic if you have Parts A and B and pay your Part B premiums. There is no fee for enrolling in TRICARE For Life. TRICARE For Life is available worldwide, and enrollment is not required. It offers secondary coverage after Medicare in the US and US Territories. In other overseas locations, TRICARE For Life is the primary payer.
When using TRICARE For Life, you don't pay any enrollment fees, but you must pay Medicare Part A and Medicare Part B monthly premiums. Medicare Part A is paid from payroll taxes while you are working. Your Part B premium is based on your income, but you must have both Medicare Parts A and B. If you get Social Security or Railroad Retirement Board benefits, your Medicare Part B premium will be deducted from your benefit payment. You can pay your Medicare Part B premiums online.
Generally, you won't have out-of-pocket costs for services that both Medicare and TRICARE cover. You will have out-of-pocket costs for care that isn't covered by Medicare and/or TRICARE. You can get care at military hospitals and clinics, but only if space is available. When using TRICARE For Life in all overseas locations, TRICARE is the primary payer, and you're responsible for paying TRICARE's annual deductible and cost shares.
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Frequently asked questions
TRICARE is a health care program that serves uniformed service members, retirees, and their families worldwide.
Medicare is a federal health insurance program for U.S. citizens aged 65 and older, under 65 with certain disabilities, or those with end-stage renal disease.
TRICARE for Life is Medicare wraparound coverage for TRICARE-eligible beneficiaries who have Medicare Parts A and B. Coverage is automatic if you have Parts A and B and pay your Part B premiums. Medicare will pay first for services, then TRICARE for Life will pay any remaining costs.
