How Do TRICARE and Medicare Work Together?

Published by: Medicare Made Clear

TRICARE® is the health care program that serves uniformed service members, retirees and their families worldwide.

 

Medicare is a federal health care program for U.S. citizens age 65 and older, under age 65 with certain disabilities and those who have end-stage renal disease.

 

You may be eligible for both TRICARE and Medicare. This article explains how TRICARE and Medicare enrollment work and also how TRICARE For Life and Medicare interact.

 

 

TRICARE and Medicare Enrollment

 

When you become eligible for Medicare at age 65, unless you meet certain exceptions, you will need to get Medicare to remain eligible for TRICARE.  This means for Medicare, you’ll need to enroll during your Medicare Initial Enrollment Period. And with TRICARE, you have 90 days after you become eligible for Medicare to change your TRICARE health plan, and your plan options will depend on your specific situation including how you qualify for Medicare, you or a family member’s active duty status and which TRICARE plan you’re currently enrolled in.1

 

Most people with TRICARE, who become Medicare eligible and get Medicare Part A, must also have Medicare Part B to be able to remain eligible. Part D is not required to maintain eligibility.

 

You can remain eligible for TRICARE without enrolling in Medicare Part B only if you are:

 

  • An active duty service member
  • An active duty family member
  • Enrolled in TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult or the US Family Health Plan.

 

It’s important to understand this and make sure you enroll in Part B when you become eligible or you may lose eligibility for any TRICARE benefits if you don’t have it when it’s required.

 

Another important note is that when you become Medicare eligible, the age of your spouse and covered family members, as well as the TRICARE plan you all were on, each play a role in your coverage options. Read more about this here  under the “Family Members” section on TRICARE’s website.

 

 

TRICARE For Life

 

TRICARE For Life is Medicare wraparound coverage for TRICARE-eligible beneficiaries who have Medicare Parts A and B. Coverage is automatic if you have Parts A and B and pay your Part B premiums.  There is no fee for enrolling in TRICARE For Life. 

 

TRICARE For Life is available worldwide and enrollment is not required. It offers secondary coverage after Medicare in the U.S. and U.S. Territories. In other overseas locations, TRICARE For Life is the primary payer.

 

 

How TRICARE For Life Works With Medicare Plans

 

TRICARE For Life may work with Original Medicare (Parts A & B), a Medicare Advantage plan or a Part D prescription drug plan.

 

However, you may want to think carefully about whether you need Medicare drug coverage. TRICARE For Life includes a prescription drug benefit, so you may not need Part D. If you have TRICARE For Life and decide you want to enroll in Part D coverage, you can do it at any time. The TRICARE drug benefit is considered “creditable coverage,” which means it is at least as good as Medicare Part D. This allows you to sign up without paying the Part D late enrollment penalty.

 

When you have TRICARE For Life and Medicare, you won’t receive a TRICARE wallet card. You only need your Medicare plan card and military ID as proof of coverage.

 

 

How Medicare and TRICARE For Life Pay Health Care Costs

 

When you have Medicare and TRICARE For Life, you can visit any authorized provider. But as mentioned before, in the U.S. and U.S. Territories, Medicare will be the primary payer. So how do the two work together to pay your health care costs?

 

  1. The provider will file the claim(s) with Medicare.
  2.  

  3. Medicare will then pay the portion it’s responsible for and then send the claim to the TRICARE For Life claims processor.

 

TRICARE For Life will pay its portion directly to the provider for the services TRICARE covers.

 

If you have further questions about or need more information about TRICARE For Life and Medicare, visit tricare.mil/tfl.

 

 

https://www.tricare.mil/medicare

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