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I am retiring from the military and I will become eligible for health coverage under the TRICARE For Life program. How does this fit in with Medicare? And how does it affect my spouse?

En español | You (and your covered spouse) become eligible for TRICARE For Life at age 65, if you’ve already retired, after at least 20 years of military service with an honorable discharge. TRICARE coverage then immediately morphs into TFL coverage, provided that you enroll in Medicare Parts A and B as soon as you’re eligible.  

Be sure to sign up for Part B a month or so before you turn 65 (or before you retire, if you’re older than 65 by then). Your TRICARE benefits abruptly come to an end on the first day of the month in which you reach 65, or the first day of the month after retirement, if you aren’t already enrolled in Part B.  

If you miss this deadline, you’ll get TFL benefits as soon as you enroll in Part B, but TFL won’t pay for any medical care you’ve received during the lapsed period.  In effect, you’ll have no coverage at all during that time — unless you have coverage from elsewhere, such as from another job or the Veteran Affairs health system. And note that the times when you can enroll in Part B, and when coverage starts, are determined by Medicare’s rules for specific enrollment periods. So if you delay Part B enrollment too long, you may not be eligible for TFL again for many months.

If you’re retired from the military and your spouse reaches age 65 before you do, he or she must transfer from TRICARE to TFL and enroll in Part B at the same time, even though you’re still receiving coverage from TRICARE. (Your current TRICARE premiums will be halved as a result.) Conversely, if you reach 65 before your spouse, he or she will stay on TRICARE until reaching Medicare age even though you’ve transferred to TFL.

Here’s how Medicare works with TFL:

  • You must pay Medicare’s Part B premiums. But you don’t pay any premiums for TFL.
  • TFL pays the other out-of-pocket costs of Medicare — your deductibles and copays — so that you get comprehensive coverage at minimal cost. You don’t need Medigap supplemental insurance.
  • TFL’s prescription drug coverage is better and less expensive than Medicare Part D drug coverage, so you don’t need to enroll in a Part D drug plan.
  • When you use a medical service that is covered by both Medicare and TFL, Medicare pays first. The provider bills Medicare, which pays its share, and the rest of the claim is sent to TFL. TFL pays the remaining share of the bill directly to the provider.
  • If you use a medical service that’s covered by Medicare but not by TFL (such as some chiropractic treatment), TFL won’t pay Medicare’s deductible or copay or anything else toward the bill.
  • If you use a service that’s covered by TFL but not by Medicare (such as health care outside of the United States), TFL pays at the same rate as the TRICARE Standard program, and you pay its deductibles and copays.

See official information on the TRICARE For Life program.

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