TRICARE for Life &
Medicare Coordination
Turning 65? TRICARE for Life (TFL) works alongside Medicare to provide comprehensive coverage with minimal out-of-pocket costs. Here's everything you need to know.
TFL is Automatic - But Medicare Enrollment is NOT
If you're a military retiree in DEERS, TRICARE for Life is automatic once you have Medicare Parts A and B. However, you MUST actively enroll in Medicare - it won't happen automatically.
How Medicare + TRICARE for Life Works
Medicare Pays First
When you receive care, Medicare processes the claim first as your primary insurance and pays its portion.
TRICARE Pays Second
TRICARE for Life then pays remaining covered costs that Medicare didn't cover, including most deductibles and copays.
You Pay Little to Nothing
For most services, you'll have minimal or zero out-of-pocket costs when both Medicare and TFL cover the service.
The Bottom Line: For most healthcare services, you'll pay $0 out of pocket when you have both Medicare and TRICARE for Life. The combination provides some of the best coverage available to retirees.
What You Must Have for TFL
Hospital insurance - usually premium-free if you or spouse worked 40+ quarters
Medical insurance - monthly premium required (~$174.70/month in 2024)
Must maintain current registration in Defense Enrollment Eligibility Reporting System
Prescription drug coverage - NOT required, TRICARE pharmacy benefits continue
Cost Comparison: Medicare Only vs. Medicare + TFL
| Service | Medicare Only | With TRICARE for Life |
|---|---|---|
| Doctor Visit | $30-50 copay | $0 |
| Hospital Stay | $1,632 deductible | $0 |
| Outpatient Surgery | 20% coinsurance | $0 |
| Preventive Care | $0 | $0 |
| Prescriptions | Part D costs | TRICARE rates |
Medicare Advantage: Why It's Usually Not Recommended
Medicare Advantage (Part C) Can Complicate Your Coverage
Many military retirees are attracted to Medicare Advantage plans for their added benefits. However, combining Medicare Advantage with TRICARE for Life creates complications:
- Claims processing becomes more complex with three payers
- You may lose TRICARE pharmacy benefits
- Network restrictions may limit provider choices
- Cost savings are often minimal or negative compared to Original Medicare + TFL
Recommendation: Stick with Original Medicare (Parts A & B) + TRICARE for Life for the simplest, most comprehensive coverage.
Frequently Asked Questions
Do I need Medicare Part D?
No. TRICARE for Life includes pharmacy coverage that's typically better than Part D. You can skip Part D without penalty as long as you have TRICARE.
What about Medicare Advantage?
Medicare Advantage (Part C) is generally NOT recommended with TRICARE for Life. It can complicate claims and you may lose TRICARE pharmacy benefits. Stick with Original Medicare (Parts A & B).
When must I enroll in Medicare?
Enroll during your Initial Enrollment Period (3 months before your 65th birthday through 3 months after). Late enrollment can mean permanent premium penalties.
What if my spouse is under 65?
Your spouse continues on their current TRICARE plan (Prime or Select) until they turn 65 and become eligible for Medicare + TFL.
Does TFL work overseas?
TRICARE for Life provides coverage overseas, but Medicare does not. When traveling abroad, TFL acts as your primary coverage for emergency and some routine care.
Key Dates: Medicare Enrollment Timeline
Initial Enrollment Period (IEP)
Your IEP is a 7-month window centered on your 65th birthday:
Missing your IEP can result in permanent premium penalties and coverage gaps.