TRICARE For Life Coverage for Medicare Users (2026 Guide)

*Disclaimer: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense or the official TRICARE program. For official policy and high-level medical decisions, visit TRICARE.mil.*

## Quick answer TRICARE For Life (TFL) is Medicare-wraparound coverage for military retirees and their eligible dependents. If you have both Medicare Part A and Part B, TFL acts as your secondary payer, automatically covering nearly all out-of-pocket costs (deductibles and coinsurance) for services covered by both programs.

## In detail TRICARE For Life is individual coverage; it is not a family plan. As long as you are registered in DEERS and have Medicare Part A and Part B, you are automatically enrolled in TFL. There are no enrollment fees or monthly premiums for TFL itself, though you must continue to pay your Medicare Part B monthly premiums.

### How Billing Works TFL works seamlessly with Medicare in the United States and U.S. Territories. * **For services covered by Medicare and TFL:** Medicare pays first, and TFL pays the remaining balance. Usually, you owe $0. * **For services covered by Medicare but not TFL:** Medicare pays its share, and you pay the TRICARE deductible and cost-share. * **For services covered by TFL but not Medicare:** TFL acts as the primary payer. You pay the TRICARE deductible and cost-share. * **Overseas:** Since Medicare does not provide coverage outside the U.S., TFL becomes the primary payer for retirees living abroad.

### 2026 Cost Factors While TFL has no "premium," your costs are tied to your Medicare status and your "Groups" (though Group A/B distinctions matter less for TFL than for Select/Prime).

### Pharmacy Coverage TFL beneficiaries are automatically covered by the TRICARE Pharmacy Program, managed by **Express Scripts**. You can fill prescriptions via military pharmacies ($0 copay), home delivery, or retail network pharmacies.

### Geographic Contractors As of 2026, claims processing for TFL is managed by: * **TRICARE East:** Humana Military * **TRICARE West:** TriWest Healthcare Alliance * **Overseas:** International SOS

## Who this applies to * **Military Retirees:** Those who have retired from active duty or the National Guard/Reserves and are age 65 or older. * **Spouses:** Eligible spouses of retirees who are age 65 or older and enrolled in Medicare Part A and B. * **Medically Retired Personnel:** Individuals under 65 who are entitled to Medicare due to a disability or End-Stage Renal Disease (ESRD). * **Survivors:** Unmarried surviving spouses of deceased service members who meet Medicare eligibility requirements.

Common scenarios

**Scenario 1: Standard Specialist Visit in the U.S.** John is a 68-year-old retired Army Major living in Texas (West Region, managed by TriWest). He visits a cardiologist for a Medicare-covered consultation. The bill is $300. Medicare pays 80% ($240). TRICARE For Life automatically pays the remaining 20% ($60). **John pays $0.**

**Scenario 2: Prescription Refill via Mail Order** Susan uses TFL and needs a 90-day supply of a brand-name maintenance medication. She uses Express Scripts Home Delivery. Under 2026 rates (hypothetically ~$38-$40 for brand formulary), she pays the standard TRICARE pharmacy co-pay. The cost is significantly lower than retail, and she has no separate deductible to meet.

**Scenario 3: Emergency Care Overseas** Robert is a retiree living in Italy. He breaks his arm. Because Medicare does not cover care in Italy, TFL acts as the primary payer. Robert pays his TRICARE deductible (varies by rank/year) and a 25% cost-share of the TRICARE-allowable amount. He must file his claim with International SOS.

## Related terms * **DEERS:** The Defense Enrollment Eligibility Reporting System; the database that verifies your military benefits eligibility. * **Medicare Part B:** The portion of Medicare that covers doctor visits and outpatient care; required to keep TFL active. * **Secondary Payer:** A health insurance plan that pays after the primary insurance (Medicare) has paid its portion. * **T-5 Contract:** The 2025/2026 regional contract transition that moved West Region administration to TriWest Healthcare Alliance. * **Standard Coordination of Benefits (COB):** The process by which two insurance plans share the cost of a claim.

## Sources * TRICARE For Life Official Site: https://tricare.mil/tfl * Medicare.gov (Part B Costs): https://www.medicare.gov * Defense Health Agency (DHA): https://health.mil * TriWest Healthcare Alliance (West Contractor): https://www.triwest.com/trw/beneficiary/index.html