How Does Medicare Work with TRICARE?

TRICARE is a health insurance program for active and retired military members, their spouses, and dependents, offering worldwide coverage. Once you turn 65, you also become eligible for Medicare. In this case, Medicare becomes your primary insurance, paying first, while TRICARE For Life acts as secondary insurance, covering costs like copayments and deductibles—as long as you’re enrolled in both Medicare Part A and Part B.

Original Medicare and TRICARE

Most people should enroll in Medicare Part A at 65 since it’s free for most. Military personnel can delay enrolling in Part B without penalties if they are on active duty, have other qualifying health coverage, or are enrolled in certain TRICARE plans.

Once they enroll in both Medicare Part A and Part B, TRICARE automatically switches to TRICARE For Life (TFL), requiring no paperwork. Medicare becomes the primary insurance, and TFL acts as secondary coverage, paying remaining costs. Prescription drug coverage is included with TFL, so there’s no need to sign up for Medicare Part D, though it remains an option.

You can choose to enroll in a Medicare Advantage plan, which often has low (or $0) premiums.

Medicare Advantage and TRICARE for Life

While Medicare and TRICARE For Life (TFL) provide strong coverage, they don’t cover certain services like dental care, vision exams, hearing aids, long-term care, acupuncture, or chiropractic services. To fill these gaps, many TFL members choose a Medicare Advantage (Part C) plan.

Medicare Advantage replaces Original Medicare but still requires you to pay the Part B premium. Some plans, especially those designed for veterans, may offer Part B givebacks to lower your premium. If you enroll in Medicare Advantage, it becomes your primary insurance, and TFL serves as secondary coverage. However, since Medicare Advantage has network restrictions, you’ll need to use in-network providers.


Unlike Original Medicare, Medicare Advantage does not automatically coordinate with TFL, so you may need to submit claims yourself for reimbursement.

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HOW DOES MEDICARE WORK WITH TRICARE

If you have TRICARE and are turning 65, you may be wondering how it works with Medicare.

At MAC Insurance, we help military retirees understand their coverage options, including how TRICARE For Life (TFL) works as secondary insurance to Medicare.

We’ll guide you through enrollment, explain costs, and help you explore additional coverage options like Medicare Advantage.

ADDITIONAL QUESTIONS TO BE ADVISED ON:

What is TRICARE For Life (TFL), and how does it work with Medicare?

TRICARE For Life (TFL) is coverage for military retirees who have Medicare Part A and Part B. Medicare pays first, and TFL covers the remaining costs, like copays and deductibles, so you have little to no out-of-pocket expenses. TFL kicks in automatically when you enroll in Medicare—no extra steps needed!

Do I need to enroll in Medicare at 65 if I have TRICARE?

Yes, if you have TRICARE, you need to enroll in Medicare Part A and Part B at 65 to keep your coverage. Once enrolled, TRICARE switches to TRICARE For Life (TFL), which works as secondary insurance to Medicare. If you're still on active duty or covered by a spouse’s job-based plan, you may delay Part B without penalties.

Do I need Medicare Part B to keep TRICARE?

Yes, to keep TRICARE For Life (TFL), you must enroll in Medicare Part B when you turn 65. If you don’t sign up, you will lose your TRICARE coverage. The only exception is if you’re still on active duty or covered by a spouse’s employer plan, in which case you can delay Part B without penalties.

Can I delay Medicare Part B enrollment if I’m still working?

Yes, if you’re still working and have health coverage through your employer (or your spouse’s job), you can delay Medicare Part B without penalties. Once that coverage ends, you’ll need to enroll in Part B to keep TRICARE For Life (TFL).

Will I have out-of-pocket costs with Medicare and TRICARE?

With Medicare and TRICARE For Life (TFL), you’ll have little to no out-of-pocket costs since TFL covers what Medicare doesn’t. However, services like dental, vision, and hearing aids aren’t covered.

How do I file claims if I have both Medicare and TRICARE?

You usually don’t need to file claims! Medicare pays first, then TRICARE For Life (TFL) automatically covers the rest. If you have a Medicare Advantage plan, you may need to submit a claim to TFL yourself.

Why was Medicare established?

Medicare was created to offer healthcare benefits to retirees. Before its introduction, retirees who lost employer-sponsored coverage had few health insurance options.

How can I check if I'm enrolled in Original Medicare?

To see if you're enrolled in Original Medicare, check your Social Security check deductions. If you're receiving Social Security benefits, you're automatically enrolled at 65, and Medicare premiums are deducted from your benefits. You can also verify your enrollment online at MyMedicare.gov or by calling the Social Security Administration.

At what age can I get Medicare?

People receiving disability benefits for 24 months qualify for Medicare at any age, as do those with ESRD or ALS. Otherwise, Medicare eligibility begins at 65.

Who does not qualify for Medicare?

To qualify for Medicare, individuals must be U.S. citizens or have lived in the U.S. for at least five years. Those under 65 without disabilities, ESRD, or ALS are not eligible.

What documents are required for a Medicare application?

You must provide proof of U.S. citizenship or legal residency, along with your birth certificate and driver's license.

Do I need a primary care physician for Medicare?

No, you don't need to select a primary care physician with Original Medicare. However, choosing providers who accept Medicare assignment can help minimize your out-of-pocket costs.

Do I have to get a referral to see a specialist if I’m on Medicare?

No, you don’t need a referral to see a specialist. However, your out-of-pocket costs will be lower if you choose a specialist that accepts Medicare assignment.

We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area, and any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all your options.

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