TRICARE vs. Medicare: How They Work Together
When military retirees turn 65, they become Medicare-eligible and transition from TRICARE Prime or Select to TRICARE For Life (TFL). TFL works as a supplement to Medicare — Medicare pays first, then TFL covers most remaining costs. You MUST enroll in Medicare Part B to keep TRICARE coverage after 65.
Eligibility
TRICARE (under 65)
Military retirees and family members under age 65, registered in DEERS.
TRICARE For Life + Medicare
Military retirees and eligible family members age 65+, enrolled in Medicare Part A and Part B.
Feature Comparison
| Feature | TRICARE (under 65) | TRICARE For Life + Medicare |
|---|---|---|
| Primary Coverage | TRICARE is primary payer | Medicare pays first, TFL pays second |
| Provider Choice | Based on plan (Prime = PCM, Select = any authorized) | Any Medicare-accepting provider |
| Referrals Required | Prime only | No |
| Enrollment Required | Yes — must enroll in Prime or Select | Automatic with Medicare Parts A & B |
| Military Pharmacy | Yes | Yes — still available |
| Overseas Coverage | TRICARE Overseas Program | Medicare doesn't cover overseas; TFL provides overseas coverage |
Cost Comparison
| Cost | TRICARE (under 65) | TRICARE For Life + Medicare |
|---|---|---|
| TRICARE Enrollment Fee | $388.32–$776.64/year | $0 |
| Medicare Part B Premium | N/A | $185/month (2025 standard) |
| Doctor Visit Out-of-Pocket | $0–$33 depending on plan | $0 in most cases (Medicare + TFL covers 100%) |
| Hospital Stay | Cost shares vary by plan | Usually $0 after Medicare + TFL |
| Catastrophic Cap | $3,500 | None needed — virtually no out-of-pocket |
Pros & Cons
TRICARE (under 65)
Pros
- No Medicare Part B premium
- Military treatment facility access
- Lower total monthly cost if healthy
Cons
- Enrollment fees for retirees
- Cost shares on most services
- Must choose Prime or Select
TRICARE For Life + Medicare
Pros
- Nearly zero out-of-pocket costs
- No referrals ever
- See any Medicare-accepting doctor
- No TRICARE enrollment fee
- Overseas coverage through TFL
Cons
- Must pay Medicare Part B premium ($185/month)
- Must be 65 or older
- Must enroll in Part B or lose TRICARE
- Medicare Part B premium increases with income
Best For
TRICARE (under 65)
Retirees under 65 who want comprehensive military healthcare coverage for their family.
TRICARE For Life + Medicare
Retirees 65 and older who want the most comprehensive, lowest out-of-pocket coverage possible. The combination of Medicare + TFL provides near-complete coverage.