TRICARE For Life and Medicare: How the Two Work Together
For military retirees and their families, TRICARE For Life picks up most of what Medicare leaves behind. It only works if you keep Medicare Part B. Here is who pays what, and the mistakes that cause gaps in coverage.
TRICARE For Life (TFL) is TRICARE's coverage for people who are TRICARE-eligible and have Medicare Part A and Part B. Medicare pays first and TFL pays second, so for care both programs cover you usually pay nothing. TFL starts automatically, has no enrollment fee, and includes prescription drug coverage. The catch: military retirees and their family members must keep Part B and pay its premium, $202.90 a month for most people in 2026, or they lose TRICARE.
TFL is often described as the best supplement a Medicare beneficiary can have. That is mostly true, but it only works if you follow the rules. The most common problems come from signing up for Part B late, dropping Part B, or seeing providers who cannot bill Medicare. This guide explains each rule using TRICARE's own handbook and Medicare's guidance.
Who gets TRICARE For Life
You have TFL if you are eligible for TRICARE and have both Medicare Part A and Part B. That includes:
- Military retirees, including retired National Guard and Reserve members drawing retirement pay
- Family members of retirees, including eligible surviving spouses and eligible former spouses
- Medal of Honor recipients and their eligible family members
- People under 65 who have Medicare because of a disability, ALS or end-stage renal disease
Coverage is per person. Your TFL does not cover a spouse who does not have Medicare yet. A spouse under 65 keeps their own TRICARE plan, such as TRICARE Prime or Select, until they get Medicare.
There is nothing to enroll in. TFL starts on the first day you have both Part A and Part B. No TFL card is issued. You show your Medicare card and your uniformed services ID card. The one thing to keep current is DEERS, the Defense Department's eligibility database. Call the DEERS Support Office at 800-538-9552 if your information is wrong.
Why Part B is not optional
If you are eligible for premium-free Part A, TRICARE requires retirees and their family members to have Part B to stay TRICARE-eligible. This applies even if you live overseas, where Medicare does not pay for care. If you drop Part B, never sign up, or stop paying the premium, your TRICARE coverage ends.
To avoid a break in coverage at 65:
- If you already get Social Security, Railroad Retirement or OPM benefits, you are enrolled in Parts A and B automatically the month you turn 65. Do not turn down Part B when the card arrives.
- If you do not get those benefits yet, sign up yourself during your Initial Enrollment Period. TRICARE advises enrolling no later than two months before you turn 65.
Signing up late has two costs. You have no TRICARE until Part B starts, and Medicare adds a late enrollment penalty of 10% to your Part B premium for each full 12-month period you could have had Part B but did not. You pay that penalty for as long as you have Part B. Our Medicare late enrollment penalty calculator shows how fast it adds up. Check when your windows open with the Medicare eligibility checker.
Exceptions to the Part B rule
| Who | Part B needed to keep TRICARE? |
|---|---|
| Retirees and their family members | Yes |
| Active duty service members | No |
| Active duty family members | No, until the sponsor retires |
| TRICARE Reserve Select, Retired Reserve, Young Adult or US Family Health Plan members | No, but TRICARE strongly encourages it to avoid a late penalty |
Active duty service members and their family members can wait. Medicare gives them a special enrollment period, with no late penalty, any time the sponsor is on active duty or within 8 months after the sponsor retires. Sign up before the retirement date, because TRICARE coverage ends on that date if Part B is not in place. This special period does not apply to people whose Medicare is based on ESRD.
Working past 65 does not change the rule for retirees. Medicare lets people with job-based coverage delay Part B, but TRICARE does not. If you have premium-free Part A and want to keep TRICARE, you need Part B even while working.
Who pays what
In the U.S. and its territories, your provider bills Medicare first. Medicare pays its share and forwards the claim to TFL, which is run by WPS Government Services. You do not file anything. TRICARE's handbook breaks down costs this way:
| Type of service | Medicare pays | TRICARE pays | You pay |
|---|---|---|---|
| Covered by Medicare and TRICARE | Medicare-allowed amount | The rest | Nothing |
| Covered by Medicare only (for example, chiropractic care) | Medicare-allowed amount | Nothing | Medicare deductible and cost-share |
| Covered by TRICARE only (for example, care overseas) | Nothing | TRICARE-allowable amount | TRICARE deductible and cost-share |
| Covered by neither (for example, most cosmetic surgery) | Nothing | Nothing | The whole bill |
A few details trip people up:
- The Part B deductible is covered. TFL pays it when the service is covered by both programs. The Part B premium is not covered. You pay that yourself.
- If Medicare denies a claim as not medically necessary, TRICARE denies it too. If you appeal and Medicare reverses its decision, TRICARE reconsiders as well.
- If you use up a Medicare benefit, such as the 100 days of skilled nursing care, TRICARE becomes the primary payer for covered care, and its deductible, cost-shares and pre-authorization rules apply.
- Other insurance changes the order. With a job-based plan from current employment, that plan usually pays first, Medicare second and TRICARE last. TRICARE pays after most other coverage, with exceptions such as Medicaid.
Watch out for VA and opt-out providers
Two kinds of providers cannot bill Medicare: VA facilities, and doctors who have opted out of Medicare. When Medicare cannot pay, TRICARE still pays only what it would have paid as the second payer, normally up to 20% of the TRICARE-allowable amount. For non-service-connected care at a VA facility, TRICARE's handbook warns you may owe about 80% of the bill. Service-connected care at the VA is a separate VA benefit. If you are eligible for both, use Medicare providers for other care. Our veterans benefits tools cover the VA side, including the VA pension calculator.
Prescription drugs
TFL includes drug coverage through the TRICARE Pharmacy Program, run by Express Scripts (877-363-1303). You do not need a Medicare Part D plan to have drug coverage. Your options:
- Military pharmacies: up to a 90-day supply of most drugs at no cost, if one is near you.
- TRICARE Pharmacy Home Delivery: up to a 90-day supply with copays and free standard shipping.
- Retail network pharmacies: copays apply. At non-network pharmacies you pay the full price and file a claim.
Some people add a Part D plan because it covers a drug TRICARE does not. If you do, Part D pays first and TRICARE pays last, and you generally cannot use TRICARE home delivery while you have Part D. Medicare's guidance treats TRICARE as coverage that protects you from the Part D late penalty, as long as you join a Medicare drug plan within 63 days of losing TRICARE. TRICARE also notes that since August 31, 2025, its pharmacy benefit does not cover weight loss drugs for TFL members when obesity is the main diagnosis.
Medicare Advantage with TRICARE For Life
You can join a Medicare Advantage plan and keep TFL, but the setup changes:
- You must use the plan's network, except in emergencies.
- You may pay copays at the time of care, and you may pay a plan premium on top of Part B.
- To get copays back for TRICARE-covered services, you file paper claims with TFL. With Original Medicare, claims move from Medicare to TRICARE without you doing anything.
- Most Medicare Advantage plans include Part D, which then pays first for your drugs.
For most people, Original Medicare plus TFL already leaves little or nothing to pay for covered care, so a Medicare Advantage plan mainly adds extras like dental or vision, in exchange for a network and more paperwork. Some plans also lower the Part B premium, which is the one cost TFL never covers. See how the Part B giveback works. If you are weighing the two paths, compare Medicare Advantage and Original Medicare, and talk to a SHIP counselor, which TRICARE itself recommends before you drop or add coverage.
A Medigap policy is optional with TFL. Since TFL already pays most of what Medigap would, many people do not need one. If you drop other coverage, tell WPS.
Living or traveling overseas
Medicare covers care only in the U.S., its territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands) and on ships in U.S. waters. Everywhere else, TRICARE pays first. You pay the TRICARE deductible and cost-shares, often pay up front and file a claim, and some care needs pre-authorization. You still must keep Part B to stay TRICARE-eligible, even though Medicare will not pay anything abroad.
Your TRICARE For Life checklist
- Before 65: confirm you will get premium-free Part A and sign up for Part B on time. Check that DEERS is current.
- At 65: keep Part B. Expect the premium to come out of your Social Security payment if you get one.
- For drugs: use TRICARE pharmacy options. Add Part D only if it covers something TRICARE does not.
- For care: use providers who bill Medicare. Call WPS at 866-773-0404 before using a VA provider for non-service-connected care.
- During open enrollment: you do not need to buy a plan to keep TFL. If you consider Medicare Advantage, check the network and the claims process first. Our Medicare Annual Enrollment Period guide covers the dates.
Frequently Asked Questions
Do I have to sign up for TRICARE For Life?
No. If you are TRICARE-eligible, TRICARE For Life starts automatically on the first day you have both Medicare Part A and Part B. There is no enrollment form and no TRICARE For Life card. You show your Medicare card and your uniformed services ID card. Make sure your information in DEERS is correct.
Does TRICARE For Life pay my Part B premium?
No. You pay the Part B premium yourself, $202.90 a month for most people in 2026. TRICARE For Life does cover the Part B deductible when a service is covered by both Medicare and TRICARE. There is no enrollment fee for TRICARE For Life.
Do I need a Medicare Part D plan if I have TRICARE For Life?
No. TRICARE For Life includes drug coverage through the TRICARE Pharmacy Program. Some people buy a Part D plan anyway because it covers a drug TRICARE does not. If you have Part D, it pays first for prescriptions and TRICARE pays last, and you may lose access to TRICARE Pharmacy Home Delivery.
Can I have TRICARE For Life and a Medicare Advantage plan?
Yes, but it changes how things work. You must use the plan's network except in emergencies, you may pay copays at the time of care, and you file paper claims with TRICARE For Life to be paid back for copays on TRICARE-covered services. With Original Medicare, claims move from Medicare to TRICARE automatically.
Does TRICARE For Life work overseas?
Yes. Medicare does not cover care outside the U.S. and its territories, so overseas TRICARE pays first and you pay the TRICARE deductible and cost-shares. You still must keep Medicare Part B to stay TRICARE-eligible, even while living abroad.
What if my spouse turns 65 while I am still on active duty?
Active duty family members do not need Part B to keep TRICARE. Medicare gives them a special enrollment period, with no late penalty, any time the sponsor is on active duty or within 8 months of retirement. Sign up for Part B before the retirement date to avoid a gap in TRICARE coverage. This does not apply to people whose Medicare is based on ESRD.
This article explains how TRICARE For Life works with Medicare as of October 2026. TRICARE eligibility depends on your DEERS record and sponsor status. This is general educational information, not insurance or legal advice. See our disclaimer. Confirm your coverage with TRICARE For Life (WPS, 866-773-0404), Medicare (1-800-MEDICARE) or Social Security (800-772-1213).