TRICARE and Medicare are not competing programs for military retirees. They work together. Before age 65, military retirees use TRICARE Prime or TRICARE Select as their primary health coverage. At age 65, retirees must enroll in Medicare Parts A and B, and their TRICARE coverage automatically transitions to TRICARE For Life (TFL), which acts as a supplement that covers most out-of-pocket costs left over after Medicare pays.
Understanding exactly how these two programs interact, what each costs, and what steps to take at each stage can save military retirees thousands of dollars per year and prevent costly gaps in coverage.
How Do TRICARE and Medicare Work Together for Military Retirees?
Military retirees experience two distinct phases of health coverage:
Phase 1: Before Age 65. Retirees choose between TRICARE Prime (managed care with lower costs but network restrictions) and TRICARE Select (more provider freedom with higher out-of-pocket costs). Medicare is not required during this phase, though some retirees may qualify for Medicare earlier due to disability.
Phase 2: At Age 65 and Beyond. TRICARE Prime and TRICARE Select eligibility ends. Retirees must enroll in both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Once enrolled in both parts, TRICARE For Life activates automatically with no separate enrollment required. TFL then serves as wraparound coverage, paying most costs that Medicare does not cover.
This transition is mandatory. If you do not enroll in Medicare Part B when first eligible, you will lose TRICARE coverage entirely until you do enroll, and you may face late enrollment penalties.
What Is TRICARE For Life and How Does It Work?
TRICARE For Life is a Medicare supplement available to all military retirees (and their eligible family members) who are enrolled in both Medicare Part A and Part B. Here is how claims are processed:
- You visit a Medicare-participating provider
- Medicare pays its share first
- TRICARE For Life automatically pays most or all of the remaining balance
- You typically pay little to nothing out of pocket for Medicare-covered services
TFL has no monthly premium of its own. Your only recurring cost is the Medicare Part B premium. There is no enrollment form for TFL. It activates automatically once Medicare Part A and Part B enrollment shows up in the Defense Enrollment Eligibility Reporting System (DEERS).
2026 Cost Comparison: TRICARE Plans vs Medicare
The table below compares costs across the main options available to military retirees at different life stages.
TRICARE Costs for Retirees Under 65 (2026)
| Cost Category | TRICARE Prime Group A | TRICARE Prime Group B | TRICARE Select Group A | TRICARE Select Group B |
|---|---|---|---|---|
| Annual Enrollment Fee (Individual) | $381.96 | $462.96 | $186.96 | $594.96 |
| Annual Enrollment Fee (Family) | $765 | $927 | $375 | $1,191 |
| Annual Deductible (Individual) | $0 | $0 | $150 | $198 (network) |
| Annual Deductible (Family) | $0 | $0 | $300 | $397 (network) |
| Annual Catastrophic Cap | $3,000 | $4,635 | $4,381 | $4,635 |
| Primary Care Copay | $26 | $26 | $38 (network) | $33 (network) |
| Specialty Care Copay | $39 | $39 | $52 (network) | $52 (network) |
| Preventive Care | $0 | $0 | $0 | $0 |
Group A includes sponsors whose initial enlistment or appointment began before January 1, 2018. Group B includes those who entered service on or after that date.
Medicare and TRICARE For Life Costs (Age 65+, 2026)
| Cost Category | Medicare Only | Medicare + TRICARE For Life |
|---|---|---|
| Medicare Part A Premium | $0 for most (with 40+ work quarters) | $0 for most |
| Medicare Part B Premium | $202.90/month ($2,434.80/year) | $202.90/month ($2,434.80/year) |
| Part A Hospital Deductible | $1,736 per benefit period | TFL covers this |
| Part B Annual Deductible | $283 | TFL covers this |
| Part B Coinsurance (20%) | You pay 20% after deductible | TFL covers the 20% |
| TFL Enrollment Fee | N/A | $0 |
| Doctor Visit Copays | 20% coinsurance | Typically $0 |
| Maximum Out of Pocket | No cap on Original Medicare | Effectively near $0 for covered services |
The key takeaway: with TRICARE For Life, your primary annual cost is the Medicare Part B premium of $202.90 per month. TFL picks up nearly everything else for Medicare-covered services.
What Are the TRICARE Pharmacy Benefits for 2026?
Military retirees have access to the TRICARE Pharmacy Program regardless of which plan they are on. Prescriptions filled at military pharmacies are always free. For other fill locations, copays for 2026 are listed below.
| Pharmacy Type | Generic (Tier 1) | Brand Name (Tier 2) | Non-Formulary (Tier 3) |
|---|---|---|---|
| Military Pharmacy | $0 | $0 | $0 |
| Home Delivery (90-day supply) | $14 | $44 | $85 |
| Retail Network (30-day supply) | $16 | $48 | $85 |
TRICARE For Life beneficiaries also have access to these same pharmacy benefits. For Medicare-covered drugs, Medicare pays first and TRICARE covers remaining copays, often reducing your cost to the TRICARE pharmacy copay amounts listed above.
Do Military Retirees Have to Enroll in Medicare Part B?
Yes. This is the most important rule for military retirees approaching age 65. You must enroll in both Medicare Part A and Part B to keep any TRICARE coverage after 65. Here is what happens in each scenario:
- Enroll in Part A and Part B: TRICARE For Life activates automatically. You have comprehensive coverage with minimal out-of-pocket costs.
- Enroll in Part A only: You lose all TRICARE coverage. Medicare Part A alone covers only hospital stays, and you have no outpatient or doctor visit coverage.
- Skip Medicare entirely: You lose all TRICARE coverage at age 65 with no health insurance at all.
The Medicare Part B premium for 2026 is $202.90 per month. Higher-income beneficiaries pay more through Income-Related Monthly Adjustment Amounts (IRMAA). If you delay Part B enrollment past your Initial Enrollment Period, you will face a permanent late penalty of 10% added to your premium for each full 12-month period you were eligible but not enrolled.
Step-by-Step: How to Transition from TRICARE to TRICARE For Life at Age 65
Follow these steps to ensure a smooth transition:
Step 1: Enroll in Medicare Part A and Part B. Contact Social Security at 1-800-772-1213 or visit ssa.gov starting three months before your 65th birthday. Your Initial Enrollment Period runs from three months before your birth month through three months after.
Step 2: Verify your DEERS information. Log in to milConnect (milconnect.dmdc.osd.mil) or call the Defense Manpower Data Center at 1-800-538-9552. Make sure your Medicare Part A and Part B enrollment is reflected in DEERS.
Step 3: TRICARE For Life activates automatically. Once DEERS shows your Medicare enrollment, TFL begins. No separate TFL enrollment form is needed.
Step 4: Get your Medicare card. Keep your Medicare card and military ID available. Providers will bill Medicare first, then TFL handles the rest.
Step 5: Review your pharmacy benefits. Decide whether to use military pharmacies, home delivery, or retail network pharmacies based on the copay structure.
Can You Use TRICARE and VA Benefits Together with Medicare?
Yes. Military retirees may be eligible for three separate health coverage systems:
- Medicare: Covers care at any Medicare-participating provider nationwide
- TRICARE For Life: Supplements Medicare, reducing out-of-pocket costs to near zero
- VA Health Care: Available for service-connected disabilities and other qualifying conditions
Important: Medicare does not pay for care received at VA facilities. If you get care at a VA hospital, the VA covers it under its own system. TRICARE For Life also does not supplement VA care. These systems operate independently, but having all three gives you maximum flexibility in choosing where to receive care.
Should You Choose Medicare Advantage Instead of Original Medicare with TFL?
This is a critical decision. If you enroll in a Medicare Advantage plan (Part C), TRICARE For Life will not pay your Medicare Advantage copays, coinsurance, or deductibles. TFL only works as a supplement to Original Medicare (Parts A and B).
Enrolling in Medicare Advantage effectively disables your TRICARE For Life benefits for most services. For the vast majority of military retirees, staying with Original Medicare plus TRICARE For Life provides better overall coverage at lower total cost than any Medicare Advantage plan.
How Does TRICARE Compare to Medicare for Retirees Under 65?
Military retirees under 65 do not need Medicare. Their TRICARE Prime or TRICARE Select coverage is generally more comprehensive and less expensive than what most civilians pay for employer-sponsored or marketplace health insurance.
| Feature | TRICARE (Under 65) | Medicare (65+) | Medicare + TFL (65+) |
|---|---|---|---|
| Monthly Premium | $0 to $99.25 (depending on plan) | $202.90 (Part B only) | $202.90 (Part B only) |
| Hospital Deductible | $0 (Prime) | $1,736 per stay | $0 (TFL covers it) |
| Doctor Visit Copay | $26 to $52 | 20% coinsurance | Typically $0 |
| Prescription Drugs | Included in plan | Separate Part D needed | TRICARE pharmacy included |
| Annual Out-of-Pocket Cap | $3,000 to $4,635 | No cap | Effectively near $0 |
| Provider Network | Network-based (Prime) or flexible (Select) | Any Medicare provider | Any Medicare provider |
Frequently Asked Questions
What happens to my TRICARE if I turn 65 and do not sign up for Medicare Part B?
You will lose all TRICARE coverage. TRICARE eligibility for retirees age 65 and older requires enrollment in both Medicare Part A and Part B. Without Part B, you cannot use TRICARE For Life or any other TRICARE plan.
Is TRICARE For Life free?
TRICARE For Life itself has no enrollment fee and no premium. However, you must pay the Medicare Part B premium ($202.90 per month in 2026) to maintain eligibility. There are no additional costs for TFL beyond what Medicare charges.
Can my spouse get TRICARE For Life?
Yes. Eligible spouses of military retirees qualify for TRICARE For Life once they turn 65 and enroll in Medicare Parts A and B. The same rules apply: both parts of Medicare are required, and TFL activates automatically.
Do I need a Medigap plan if I have TRICARE For Life?
No. TRICARE For Life functions similarly to a Medigap (Medicare Supplement) policy, covering most costs that Original Medicare leaves behind. Purchasing a separate Medigap plan would be redundant and unnecessary.
What if I am medically retired before age 65?
Medically retired service members may qualify for Medicare before age 65 through Social Security Disability Insurance (SSDI). After 24 months of receiving SSDI benefits, you become eligible for Medicare. At that point, you should enroll in Parts A and B, and TRICARE For Life will become your coverage regardless of age.
How do I check if I am eligible for TRICARE or Medicare benefits?
Use our free benefits screening tool to check your eligibility for TRICARE, Medicare, and dozens of other federal and state assistance programs in minutes. It covers all 50 states and provides personalized next steps based on your situation.
Key Takeaways
- TRICARE and Medicare are partners, not competitors, for military retirees
- Before 65: use TRICARE Prime or Select as your primary coverage
- At 65: you must enroll in Medicare Part A and Part B to keep any TRICARE benefits
- TRICARE For Life activates automatically once Medicare enrollment is in DEERS
- TFL has no premium of its own; your cost is the Medicare Part B premium ($202.90/month in 2026)
- Do not enroll in Medicare Advantage if you want to use TRICARE For Life
- Military pharmacy prescriptions remain free at any age
- Use our free benefits screener to check your eligibility for all available programs
