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TriCare and Medicare

Find out more about how TriCare military health benefits work with Medicare.

Q. My wife and I currently receive TriCare military health benefits. What happens when we turn 65 and transfer to the TriCare-for-Life program? Will we need Medicare as well?

A. Yes – if you’re already retired or plan to retire at age 65. In fact, under federal law, in these circumstances you must sign up for Medicare as soon as you become eligible to ensure that you continue to get benefits under the TriCare-for Life (TFL) program.  However, if you remain on active duty beyond 65, you (and your covered spouse) would continue to receive regular TriCare until you retire.

When you are enrolled in both Medicare and the TFL program, you must pay the Medicare Part B premium ($115.40 a month in 2011, or more if your income is over a certain level) but there is no premium to pay for TFL. Your medical bills will be paid first by Medicare, and TFL will pay for almost anything else that Medicare doesn’t cover—including Medicare’s deductibles and copays. In effect, TFL functions as comprehensive supplementary insurance to Medicare. TFL also provides prescription drug benefits that are far more generous than those available under the Medicare Part D drug program, so you won’t need to sign up for Part D.

This rule applies to your wife as well if you are no longer on active service with the military. If she reaches age 65 before you do, she must transfer from TriCare to TFL and join Medicare Part B at that time, even though you are still receiving TriCare. (Your current TriCare premium will be halved as a result.) Similarly, if you reach 65 before your wife, she’ll stay on TriCare after you’ve transferred to TFL until she too reaches Medicare age.

If you or your spouse become eligible for Medicare under age 65 because of disability, the same rules apply.

Be aware that if you don’t enroll in Medicare when you’re supposed to under these rules, your TriCare benefits will cease and you would probably be required to repay TriCare for the cost of any medical services you had used since becoming eligible for Medicare.

TriCare’s website has more information about how TriCare works with Medicare.

Patricia Barry is a senior editor at the AARP Bulletin.

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