When you (or your military sponsor) retire from the military, you remain on regular Tricare. You can choose either Prime or Select and pay the retired premiums, deductibles, and co-payments. Your regular Tricare coverage ends when you turn 65. Once you turn 65, you are eligible for Tricare for Life. TFL acts as wrap-around coverage for your Medicare coverage. You must be signed up for Medicare Parts A and B in order to use TFL benefits.
Transitioning from Tricare To Tricare For Life
To use Tricare for Life, you must:
- be enrolled in Medicare Parts A and B
- be paying Medicare Part B premiums
- have up-to-date DEERS information
Enrollment in Medicare should happen in the three months prior to your 65th birthday, giving plenty of time for the coverage to start when you turn 65. If you don’t enroll during that window, you can enroll during the months after your birthday without penalty, but your coverage will be delayed and you will have a gap in coverage.
There are no enrollment forms or premiums for TFL.
Your TFL coverage starts on the first day you have Medicare Parts A and B coverage. If you do not enroll in Medicare before your birthday, you may have a gap in coverage.
How Tricare For Life Works
Once you are covered for Medicare and TFL, you can see any doctor that accepts Medicare. You will use your Medicare card and your military ID as your insurance cards. It can be a little tricky to figure out who pays for what. However, as long as you are using Medicare participating or non-participating providers, nearly all your care should be covered in full.
The provider will bill Medicare for your care. Medicare will pay its portion. Any remaining portion is submitted to the Tricare for Life contractor, who will pay its portion.
The 2023 Tricare for Life Cost Matrix does a great job of explaining who pays for what in a simple format. There is also a great Tricare For Life_Handbook that answers a lot of question, especially about participating, non-participating, and opt-out providers.
You may continue to use a Military Treatment Facility if that is permitted by the individual facility.
Medicare Part D
Tricare for Life has comprehensive prescription drug coverage and you don’t need to sign up for Medicare Part D coverage. You may continue to use Military Treatment Facility pharmacies, eligible civilian pharmacies, or the Express Scripts mail-order program.
Other Family Members
Family members who are not using Medicare will continue being covered by their usual Tricare coverage.