TRICARE and Medicare: Do You Need Both at 65?
Turning 65 with TRICARE? Learn how Medicare and TRICARE work together, when Medicare Part B may be required, and what to know before enrolling.
If you have TRICARE and are turning 65, Medicare usually becomes an important part of your coverage. For most TRICARE-eligible retirees and family members who qualify for premium-free Medicare Part A, you also need Medicare Part B to keep TRICARE coverage. Once both Part A and Part B are active, TRICARE For Life generally begins automatically.
Here’s how TRICARE and Medicare work together, what changes at 65, and what to review before you enroll.
How Does TRICARE Work With Medicare?
TRICARE For Life is Medicare-wraparound coverage for eligible military retirees and family members who have both Medicare Part A and Part B. You don’t submit a separate enrollment application for TRICARE For Life. Coverage starts when both Medicare Part A and Part B are in effect.
In the United States, Medicare generally pays first for Medicare-covered services and TRICARE For Life pays second for TRICARE-covered services. When a service is covered by both programs, your out-of-pocket cost may be $0. Costs can be different when a service is covered by only Medicare, only TRICARE, or neither program.
You will still be responsible for your Medicare Part B premium.
Do I Need Medicare Part B With TRICARE?
For most retired service members and eligible family members who qualify for premium-free Medicare Part A, yes.
TRICARE says you generally must have both Medicare Part A and Part B to keep TRICARE once you become Medicare-eligible. If you turn 65 without Part B, you can have a gap in TRICARE coverage. TRICARE recommends enrolling in Medicare Part B no later than two months before turning 65 if you’re eligible for premium-free Part A, which can help prevent a break in coverage.
There are some exceptions. For example, different rules may apply if your sponsor is still on active duty or if you aren’t eligible for premium-free Medicare Part A.
What Is TRICARE For Life?
TRICARE For Life, often called TFL, is the TRICARE coverage available to eligible beneficiaries who have Medicare Part A and Part B.
It is not a separate Medicare Supplement policy, and there is no separate TFL enrollment fee. Your eligibility is tied to Medicare and your TRICARE eligibility. TRICARE For Life is also available worldwide, although the way claims are handled can differ outside the United States because Medicare generally doesn’t cover care overseas.
Do I Need Medicare Part D With TRICARE?
Usually, no.
TRICARE For Life includes prescription drug coverage through the TRICARE Pharmacy Program, so you do not need Medicare Part D simply to have prescription coverage. TRICARE also considers its prescription coverage creditable, which can protect you from a Part D late-enrollment penalty if you decide to enroll later.
There can still be situations where someone chooses a Part D plan—for example, if a particular Part D formulary covers medications differently or if the person qualifies for Medicare Extra Help. Because formularies and costs vary, it’s worth comparing before adding Part D.
Can I Have Medicare Advantage With TRICARE For Life?
Yes. Enrolling in a Medicare Advantage plan does not automatically make you lose TRICARE For Life.
You still have Medicare, and TRICARE For Life can remain secondary for TRICARE-covered services. However, Medicare Advantage plans have their own provider networks, rules, and claims processes. TRICARE notes that Medicare Advantage claims do not automatically cross over to TRICARE, so you may sometimes need to file claims yourself for reimbursement.
That means a Medicare Advantage plan should be reviewed carefully before enrolling, especially if keeping things simple is important to you.
What If I Also Use VA Health Care?
VA health care and Medicare are separate systems. VA health care generally covers eligible care provided through VA facilities or authorized community care. Medicare can provide access to Medicare-covered doctors and hospitals outside the VA system. VA says you can use VA health benefits alongside Medicare, TRICARE, or other coverage.
VA prescription coverage is considered creditable for Medicare Part D. However, VA specifically advises Veterans not to drop or decline Medicare solely because they are enrolled in VA health care.
One important point: VA health care by itself generally does not create the same Part B Special Enrollment Period that active employer group coverage can provide. Medicare’s standard Part B Special Enrollment Period is generally tied to coverage based on current employment.
What Should I Do Before Turning 65?
A few months before your 65th birthday, I’d review these items:
Confirm whether you qualify for premium-free Medicare Part A.
Check when Medicare Part A and Part B should begin.
Make sure your DEERS information is current.
Review how your TRICARE coverage will change when Medicare starts.
Compare your prescription coverage before adding Part D.
Review any employer or VA coverage you also have.
Decide whether Original Medicare with TRICARE For Life or another Medicare option fits your situation best.
TRICARE specifically recommends signing up early enough to avoid a gap in coverage and keeping your DEERS information current.
The Bottom Line
For most TRICARE-eligible retirees and family members turning 65, Medicare and TRICARE are designed to work together—not replace one another.
If you’re eligible for premium-free Medicare Part A, having Medicare Part B is usually required to keep TRICARE and move into TRICARE For Life. Part D generally isn’t required because TRICARE already includes prescription drug coverage. Medicare Advantage is also possible, but it adds another layer of rules that should be reviewed carefully.
If you’re approaching 65 and have TRICARE, VA benefits, employer coverage, or a combination of them, reviewing everything together before you enroll can help you avoid coverage gaps and unnecessary surprises.
Turning 65 with TRICARE or VA benefits? Schedule a Medicare review with Shawn to go over how your coverage works together and what you may need to do next.
This article provides general educational information. Medicare, VA and TRICARE rules may vary based on individual circumstances.
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