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Do I need to enroll in Medicare at 65 if I’m a military retiree with Tricare?

Yes. To continue Tricare benefits after you turn 65, you must enroll in Medicare Part A and Part B.

  • Tricare is the health care program for active-duty service members, military retirees and eligible family members.
  • Tricare for Life is for those eligible for Tricare who are at least 65 or qualify for Medicare early because of a disability. It’s designed to supplement Medicare, much like Medigap plans do for many of those who sign up for original Medicare.

If you retire from the military and receive Tricare benefits before age 65, your coverage changes to Tricare for Life when you enroll in Medicare. If you don’t enroll in Medicare by 65, your Tricare benefits end the first day of the month you reach 65.

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It’s important to sign up for Medicare at least a month before you turn 65 to allow yourself enough time to receive your Medicare card in the mail before coverage begins.

If you don’t sign up within your Medicare initial enrollment period, which begins three months before the month you turn 65 and lasts for three months afterward, you may have to pay a late enrollment penalty if you sign up later — unless you have health insurance from a current employer.

Tricare is different from the U.S. Department of Veterans Affairs (VA) health care benefits, which have different rules for coordinating with Medicare. For more information about the health benefits available for veterans, active-duty service members and military families, see AARP’s Veterans Health Benefits Navigator.

How does Tricare for Life differ from Tricare?

If you have Tricare coverage, that can be your primary health insurance before you turn 65 or qualify for Medicare early because of a disability. After you enroll in Medicare, Tricare for Life wraps around your Medicare coverage.

Tricare has several coverage options depending on whether you’re on active duty or a military retiree. Some types of Tricare contract with hospitals and medical personnel that deliver care at a lower cost to you than out-of-network services, similar to a health maintenance organization (HMO) or preferred provider organization (PPO). After you retire from the military, Tricare can be your primary coverage or you can use it to supplement coverage from another employer until you turn 65.

Tricare for Life fills in many gaps in Medicare. When you sign up for Medicare Part A and Part B, Tricare for Life covers Medicare’s deductibles and copayments, provides prescription drug coverage and includes extra benefits such as health care outside the United States. You can generally use any provider who accepts Medicare.

Military retirees who have Tricare automatically move to Tricare for Life when they enroll in Medicare Part A and Part B. You don’t need to submit special paperwork, but you must sign up for both parts of Medicare to receive Tricare for Life.

In two scenarios, military personnel or retirees face different rules:

  • If you’re still on active duty at 65, regular Tricare will continue to cover you until you leave the military. Your Tricare will end the first day of the month after you retire unless you sign up for Medicare Part A and Part B. Then you’ll make the transition to Tricare for Life.
  • If you can’t receive premium-free Part A because neither you nor your spouse has paid at least 40 calendar quarters of Medicare payroll taxes, you’ll stay in Tricare but have to take steps to do so. Very few fall into this exception because military personnel have had Medicare taxes deducted from their pay since the program started.

Couples may be eligible at different times. As you and your spouse near your 65th birthdays, think about your personal Tricare coverage as an individual policy, like Medicare is, not as a family plan. An older spouse — or a younger spouse who qualifies for early Medicare because of a disability — can receive Tricare for Life benefits after signing up for Medicare Parts A and B. A spouse younger than 65 remains in Tricare. 

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Tricare for Life coverage begins the first day you have Medicare Part A and Part B. You must pay Medicare Part B premiums, which are $164.90 a month in 2023 or more for high earners. However, Tricare for Life has no separate premium.

If you’re still on active duty and your spouse qualifies for Medicare benefits because of a disability, your spouse isn’t required to enroll in Part B to keep Tricare benefits. But your spouse will need to enroll in Medicare before your active duty ends to avoid a break in coverage.

What if I’m a military retiree working elsewhere at age 65?

You can delay signing up for Medicare without penalty if you or your spouse are still working at age 65 and you have health coverage from that employer. But after you reach 65, you won’t have Tricare, which you may have used to supplement your employer’s coverage. Your Tricare for Life coverage won’t take effect until you sign up for Medicare Part A and Part B.

If you or your spouse are still working, you’re eligible for a special enrollment period. You can sign up for Medicare at any time while you’re employed or within eight months of leaving the job or stopping the employer’s insurance.

How does Tricare for Life work with Medicare?

Primary vs. secondary. When you have Tricare for Life and Medicare, Medicare is the primary coverage that gets billed first. Tricare for Life is secondary.

After Medicare pays its share, the rest of the claim is sent to Tricare for Life. Tricare for Life pays the remainder of the bill directly to the provider. It also covers most of Medicare’s out-of-pocket costs, including deductibles and copayments, so you don’t usually need a Medigap policy.

Not all is covered. If you use a medical service that Medicare but not Tricare for Life covers, such as some chiropractic care, Tricare for Life won’t pay anything toward the bill. In that case, you will have to pay what Medicare doesn’t.

If Tricare for Life covers something that Medicare doesn’t, such as health care outside the United States, Tricare for Life pays the same rate as regular Tricare. You pay any deductibles and copayments.

Want more details? See the federal Defense Health Agency’s Tricare for Life page, which includes a link to the Tricare for Life handbook, for more information about eligibility, enrollment and coverage.

Do I need a Part D prescription plan if I have Tricare for Life?

No. When you’re enrolled in Tricare for Life, you have prescription drug coverage under the Tricare pharmacy program.

This coverage is considered as good or better than Medicare Part D, which the Centers for Medicare & Medicaid Services calls “creditable coverage.” That means you won’t have to pay a late enrollment penalty if you have that coverage instead of Part D.

If you do purchase a Part D prescription drug plan while covered by Tricare for Life, the Part D policy pays first. The Tricare pharmacy program pays second for Tricare-covered medicine.

Keep in mind

You must pay the $164.90-a-month Part B premium, or more for high earners, to have Tricare for Life coverage. If you have low income and assets, you may qualify for a Medicare Savings Program, which can help pay your Medicare premiums, deductibles and copayments.

You also may be eligible for the Extra Help program, which can help pay Part D premiums and copayments if you decide to enroll in Part D prescription coverage.

Updated February 22, 2023


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