Tricare is military health insurance, not Medicare

Tricare is the health insurance program for active-duty service members, retirees, and their families. Medicare is the federal health insurance program for people 65 and older, regardless of military service. They are separate programs run by different agencies — Tricare by the Department of Defense, Medicare by the Centers for Medicare & Medicaid Services.

If you are a military retiree or family member, you have Tricare. If you turn 65, you become may be able to access for Medicare. Many military retirees end up with both, and they work together in a specific way. Understanding which one pays first, and what you still owe, matters for your out-of-pocket costs.

Key Takeaways

  • Tricare is military health insurance; Medicare is federal health insurance for people 65 and older — they are two different programs.
  • Military retirees who turn 65 must enroll in Medicare Part A and Part B to keep Tricare coverage working as intended.
  • When you have both, Medicare pays first for covered services, and Tricare pays what Medicare does not cover.
  • If you do not enroll in Medicare Part B when you first become may be able to access, you may lose Tricare coverage or face higher costs.
  • Tricare for Life is a separate Tricare plan available only to people 65 and older who have both Tricare and Medicare.

How Tricare and Medicare coordinate when you have both

When you are 65 or older and have both Tricare and Medicare, Medicare becomes your primary insurance. That means Medicare pays its share of the bill first. Tricare then pays as a secondary insurance — it covers some or all of what Medicare did not pay, depending on which Tricare plan you have.

This coordination is called coordination of benefits. It reduces what you owe out of pocket, because two insurers are sharing the cost. However, it only works if you are enrolled in both Medicare Part A and Part B. If you skip Medicare Part B, Tricare may not cover you the same way, and you could face unexpected bills.

Tricare for Life: The plan designed for people with Medicare

Tricare for Life is a Tricare plan created specifically for people 65 and older who have both Tricare and Medicare. It is available to military retirees, their spouses, and survivors who meet the age and service requirements. Tricare for Life works alongside Medicare and typically covers most of what Medicare does not pay, including copayments, coinsurance, and deductibles.

To be covered by Tricare for Life, you must be enrolled in Medicare Part A and Part B. You do not pay a monthly premium for Tricare for Life itself, but you must continue paying your Medicare Part B premium. Many military retirees find Tricare for Life valuable because it fills gaps in Medicare coverage and keeps their out-of-pocket costs low.

What happens if you do not enroll in Medicare when you turn 65

If you are a Tricare member and you turn 65, you should enroll in Medicare Part A and Part B during your initial enrollment window. This window opens three months before the month you turn 65 and closes three months after. If you miss this window, you may face a permanent penalty on your Medicare Part B premium, and your Tricare coverage may change.

Some Tricare plans will continue to cover you if you do not enroll in Medicare, but you will likely pay more out of pocket. The safest approach is to enroll in Medicare Part A and Part B as soon as you are may be able to access, even if you plan to stay on Tricare. You can have both at the same time with no conflict.

Tricare plans available to people 65 and older

If you are 65 or older and may be able to access for Tricare, your main options are Tricare for Life and Tricare Select. Tricare for Life is the plan most retirees choose because it works with Medicare and typically costs less. Tricare Select is also available to some retirees and offers more flexibility in choosing providers, but it requires you to pay an annual enrollment fee and higher out-of-pocket costs.

You cannot enroll in Tricare Prime (the HMO-style plan) after you turn 65 unless you are on active duty or a family member of someone on active duty. If you are already in Tricare Prime when you turn 65, you can stay in it, but you must also enroll in Medicare Part A and Part B for it to work properly with Tricare.

How to enroll in Medicare if you have Tricare

You enroll in Medicare through Social Security, not through Tricare. You can explore online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. You should start the process about three months before you turn 65 to make sure your coverage begins on time.

When you explore, tell Social Security that you have Tricare. This helps may support your records are correct and that Medicare and Tricare coordinate properly. Keep copies of your Medicare enrollment confirmation and your Medicare card. You will need both to update your Tricare information and to show providers that you have both insurances.

Costs: Medicare premiums, Tricare premiums, and out-of-pocket expenses

Medicare Part A (hospital insurance) is usually free if you or your spouse paid Medicare taxes while working. Medicare Part B (medical insurance) has a monthly premium that varies based on your income; in 2024 it ranges from about $174 to $560 per month, but the exact amount depends on your income from two years prior.

Tricare for Life has no monthly premium, but you must pay your Medicare Part B premium to stay enrolled. Tricare Select has an annual enrollment fee (which varies by family size) plus copayments for visits and prescriptions. When you have both Medicare and Tricare for Life, your out-of-pocket costs are typically lower than Medicare alone, because Tricare covers most of what Medicare does not pay.

Frequently Asked Questions

Do I have to choose between Tricare and Medicare?

No. If you are 65 or older and may be able to access for both, you should have both. They work together, with Medicare paying first and Tricare paying second. You cannot drop Medicare to keep only Tricare without losing coverage or paying more.

What if I am still working at 65 and have Tricare through my employer?

If you are on active duty or a family member of someone on active duty, you may have different rules. Contact your Tricare regional office or visit tricare.mil to confirm your enrollment requirements. If you are a retiree with Tricare, you should still enroll in Medicare Part A and Part B at 65.

Can I use any doctor with Tricare for Life?

Tricare for Life works with any provider who accepts Medicare. You do not need to choose a primary care doctor or get referrals. However, using in-network providers (those who accept Medicare assignment) usually costs you less out of pocket.

What if I am a surviving spouse of a military member?

Surviving spouses may be may be able to access for Tricare and Tricare for Life at 65. may be able to access depends on the length of the marriage and the service member's status. Contact Tricare or visit tricare.mil to confirm your status and enrollment options.

Does Tricare cover prescription drugs?

Yes, Tricare covers prescription drugs through its pharmacy program. When you have both Tricare and Medicare, Medicare Part D (prescription drug coverage) and Tricare coordinate. You do not need to enroll in a separate Medicare Part D plan if you have Tricare for Life, as Tricare's coverage is considered creditable.