When you (or your military sponsor) retire from the military, you remain on “regular” Tricare. This “regular” Tricare coverage ends when you turn 65. Once you turn 65, you lose eligibility for Tricare and become 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. 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 2026 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.
What If You Still Have Employer Health Insurance?
Folks who are still covered by an employer health plan have some choices to make.
From the Tricare and Medicare Turning Age 65 brochure:
“However, if you’re entitled to premium free Medicare Part A, you must also have Part B to remain TRICARE-eligible, even if you have employer-sponsored coverage…TRICARE won’t act as secondary payer to your employer-sponsored health plan until you have Medicare Part B. Your TFL coverage begins on the first day you have both Medicare Part A and Part B.”
You lose eligibility for Tricare Select, Prime, or Overseas when you turn 65 (unless your sponsor is still serving – it happens!). If you choose not to enroll in Medicare Part B because you have Other Health Insurance, you’re not eligible for Tricare for Life until you enroll in Medicare Part B. You will have to figure out what option is best for your situation.
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.
You can find more information about the TFL program at the Tricare website or the Tricare for Life website.
How soon before my 65th birthday (Oct 1st) can I sign up for Medicare, tricare for life?
So from the Cost Matrix you posted. What happens if Medicare doesn’t pay for something that usually would be. Example: Bloodwork (Lab Services). Let’s say your doctor orders several blood tests but Medicare feels they were not clinically necessary and denies them. (Something I hear happens often when people try to do an Annual Exam). Now Tricare usually covers all Lab Work. So in that case, would Tricare just pay the 100% of Lab Services.
Also, how can I subscribe. I got a popup, but didn’t do it right then. Now I can’t get the same pop-up.