Tricare For Life is Medicare's secondary insurance for military retirees and their families

Tricare For Life is a health plan run by the Department of Defense for people who are retired from the military, their spouses, and survivors. If you have both Medicare and Tricare For Life, Tricare For Life pays the costs that Medicare does not cover — copayments, coinsurance, and deductibles. Medicare is always your primary insurance, meaning it pays first. Tricare For Life then covers most of what Medicare leaves behind.

You must be enrolled in both Medicare Part A and Part B to use Tricare For Life. You cannot use Tricare For Life alone, and it does not replace Medicare. The two plans work together, with Medicare handling the main bill and Tricare For Life handling the gap.

Tricare For Life is available only to people age 65 and older who are may be able to access for Medicare. If you are a military retiree, a surviving spouse, or a former spouse who meets certain length-of-marriage rules, you may be able to enroll. Active-duty service members and their families use different Tricare plans and cannot use Tricare For Life.

Key Takeaways

  • Tricare For Life covers the costs that Medicare does not pay, such as copayments and deductibles, but only after Medicare has processed the claim first.
  • You must be enrolled in both Medicare Part A and Part B before you can use Tricare For Life; Medicare is always the primary payer.
  • Military retirees, their spouses, and some former spouses age 65 and older are the main groups who can use Tricare For Life.
  • You enroll in Tricare For Life through the Defense Enrollment may be able to access Reporting System (DEERS), and enrollment is automatic for many retirees who are already in the system.
  • Tricare For Life covers services at any Medicare-approved provider in the United States, with no network restrictions like some other health plans have.

How the two plans pay together

When you see a doctor or go to the hospital, Medicare processes the claim first. Medicare pays its share based on what it considers a reasonable charge for that service. You are responsible for any copayment or coinsurance that Medicare requires. Tricare For Life then receives the claim and pays most or all of that copayment or coinsurance amount.

For example, if you have an office visit that costs $100, Medicare might pay $80 and require you to pay a $20 copayment. Tricare For Life would then pay that $20 copayment, leaving you with no bill. If Medicare has a deductible you have not yet met, Tricare For Life can pay that deductible as well.

The key rule is that Tricare For Life will not pay more than what Medicare allows for a service. If you see a provider who does not accept Medicare, Tricare For Life will not cover the visit at all. This is why staying within Medicare-approved providers matters.

Who can enroll in Tricare For Life

You must meet three requirements to use Tricare For Life: you must be age 65 or older, you must be enrolled in Medicare Part A and Part B, and you must be may be able to access for Tricare based on your military service or family connection.

Military retirees who served on active duty and are now retired are may be able to access. Spouses of military retirees are may be able to access if they are age 65 or older and enrolled in Medicare. Surviving spouses and former spouses may also be may be able to access, but the rules depend on when the marriage ended and how long it lasted. The Department of Defense website has a tool to check your specific may be able to access based on your service record.

You do not have to be a veteran yourself to use Tricare For Life. If you are the surviving spouse of a military retiree, you may be may be able to access even if you never served. The same applies to former spouses, though there are length-of-marriage and age requirements that vary.

How to enroll and when enrollment happens

Most military retirees are already in the Defense Enrollment may be able to access Reporting System (DEERS), which is the military's record-keeping system for benefits. If you are in DEERS and you turn 65 while enrolled in Medicare Part A and Part B, you are usually enrolled in Tricare For Life automatically. You do not have to submit a separate form.

If you are not automatically enrolled, you can enroll through the Tricare website or by calling the Tricare customer service line. You will need to provide proof of your Medicare enrollment and your military service record. The enrollment process is straightforward and usually takes a few minutes over the phone.

There is no cost to enroll in Tricare For Life itself, though you must continue paying your Medicare Part B premiums. Tricare For Life has no separate monthly premium, but you may have small copayments at the point of care depending on the type of service.

What Tricare For Life covers and what it does not

Tricare For Life covers the same services that Medicare covers, because it only pays the costs that Medicare leaves unpaid. If Medicare covers a doctor's visit, hospital stay, or prescription drug, Tricare For Life will cover the copayment or coinsurance. If Medicare does not cover a service, Tricare For Life will not cover it either.

Tricare For Life does not cover services outside the United States except in very limited cases. If you travel abroad and need medical care, you will need to pay out of pocket unless you are in a U.S. military hospital or a U.S. territory. This is different from some other Tricare plans that offer limited overseas coverage.

Prescription drugs are covered through Medicare Part D, not through Tricare For Life. You must enroll in a Part D plan separately. Tricare For Life will help pay the copayments and coinsurance for drugs covered by your Part D plan, but it does not replace Part D enrollment.

Costs and copayments under Tricare For Life

Tricare For Life has no monthly premium. You pay only the small copayments that Medicare requires at the time of service. For most office visits, the copayment is between $0 and $15. For hospital stays, you may have a small copayment per day, though Medicare Part A covers most of the cost.

The exact copayment amounts depend on the type of service and whether you see a provider who accepts Medicare assignment. Providers who accept Medicare assignment agree to accept Medicare's approved amount as payment in full, which means you pay only the copayment Tricare For Life does not cover. If a provider does not accept assignment, you may owe more.

You continue to pay your Medicare Part B premium each month. This premium is deducted from your Social Security check if you receive Social Security benefits. Tricare For Life does not pay this premium for you, though some military retirees may be may be able to access for other programs that help with Medicare costs.

Using Tricare For Life at the doctor and hospital

When you see a doctor or go to the hospital, tell the provider that you have both Medicare and Tricare For Life. Give them your Medicare card and your Tricare For Life card. The provider will submit the claim to Medicare first, and Medicare will process it and send the results to Tricare For Life automatically.

You do not need to choose a primary care doctor or stay within a network. You can see any doctor or hospital that accepts Medicare, anywhere in the United States. This gives you more freedom than some other health plans, but it also means you are responsible for making sure the provider accepts Medicare before you schedule an appointment.

If a provider tells you they do not accept Medicare, they will not accept Tricare For Life either. Ask the provider's office to check their Medicare status before you schedule. Many providers accept Medicare, so finding care is usually not difficult.

Frequently Asked Questions

Do I have to enroll in Tricare For Life, or does it happen automatically?

If you are already in DEERS and you turn 65 while enrolled in Medicare Part A and Part B, enrollment is automatic. You do not have to do anything. If you are not automatically enrolled, you can enroll through the Tricare website or by phone at no cost.

What happens if I do not enroll in Medicare Part B?

You cannot use Tricare For Life without Medicare Part B. If you delay enrolling in Part B, you may face a permanent penalty on your premiums. It is important to enroll in both Part A and Part B before or when you turn 65, even if you are still working.

Can I use Tricare For Life if I live outside the United States?

Tricare For Life covers care only in the United States, with rare exceptions for U.S. military hospitals and territories. If you move abroad, you will need to arrange your own health insurance. Some retirees maintain Tricare For Life enrollment and return to the U.S. for major medical needs.

Does Tricare For Life cover prescription drugs?

Tricare For Life does not replace Medicare Part D. You must enroll in a Part D plan separately to cover prescription drugs. Tricare For Life will pay the copayments and coinsurance for drugs covered by your Part D plan, but it does not provide drug coverage on its own.

What if my doctor does not accept Medicare assignment?

If a provider does not accept Medicare assignment, you may owe more than the standard copayment. Ask the provider's office about their Medicare status before your visit. Most providers accept assignment, which means you pay only the small copayment that Tricare For Life does not cover.