Do I have to enroll in Medicare at 65 if I’m a military retiree with Tricare?

Yes. After 65, you must enroll in Medicare Parts A and B to keep Tricare.

Tricare is a healthcare program for active-duty service personnel, military retirees, and their families. But it’s mainly for those younger than 65.

Tricare for Life is for people at least 65 of age or who qualify for Medicare early due to a disability. It’s supposed to supplement Medicare as Medigap plans do for people with original Medicare.

After retiring from the military with Tricare before age 65, your coverage becomes Tricare for Life when you enroll in Medicare. If you don’t enroll in Medicare by 65, Tricare ends the month you turn 65.

Enroll in Medicare at least a month before you’re 65 so you’ll have time to get your Medicare card before coverage begins.

How is Tricare for Life different from Tricare?

The main difference is Medicare coverage, introduced at age 65 or in the 25th month of Social Security Disability Insurance (SSDI). With Tricare for Life, you can generally use any provider that accepts Medicare.

Tricare provides several coverage choices depending on whether you’re a military retiree or on active duty. Some Tricare types have contracts with hospitals and medical personnel that provide care at a lower cost than out-of-network services. After retiring from the military, Tricare can be your primary coverage or a supplement until you reach 65.

Tricare for Life covers a lot. When you join Medicare Part A and Part B, Tricare for Life pays deductibles and copayments, offers prescription medication coverage, and includes supplementary benefits like health care outside the U.S.

Military retirees with Tricare automatically transfer to Tricare for Life when they enroll in Medicare Parts A and B. No additional paperwork is required, but you must enroll in both parts of Medicare to get Tricare for Life.

Small groups of people are subject to different rules

If you’re in active service at 65, Tricare will cover you until you depart. Your Tricare will end on the first day of the month after you retire unless you enroll in Medicare Parts A and B. Then you’ll switch to Tricare for Life.

If you can’t get premium-free Part A since neither you nor your spouse has paid 40 calendar quarters of Medicare taxes, you’ll remain in Tricare, but you must make efforts to do so. Very few are exempt since military pay has included Medicare taxes since the program began.

Different dates apply to couples. When you and your spouse reach 65, think of Tricare as individual insurance, like Medicare, not a family plan. A spouse who qualifies for early Medicare due to a disability can get Tricare for Life after enrolling in Medicare Parts A and B. A spouse under 65 remains in Tricare.

Tricare for Life begins the day you have Medicare Part A and Part B. You must pay  Medicare Part B premiums of $170.10 per month in 2022 or more for higher earners. But Tricare for Life comes at no separate premium.

If you’re still on active duty and your spouse qualifies for Medicare due to a disability, they don’t need to enroll in Part B to keep Tricare. But your spouse must enroll in Medicare before you finish active duty to prevent a coverage gap.

What if I’m a military retiree working somewhere else at 65?

You can defer Medicare enrollment penalty-free if you or your spouse still work at 65 and have employer-provided health insurance. However, after you are 65, you won’t have Tricare, which you might have used to supplement the employer’s coverage. Your Tricare for Life coverage won’t begin until you enroll in Medicare Parts A and B.

Since you or your spouse are still working, you’d qualify for a special enrollment period. You can enroll in Medicare while employed or within eight months of leaving your job or quitting private insurance.

How do Tricare and Medicare work together?

Primary vs. secondary: If you have Tricare for Life and Medicare, Medicare is billed first, while Tricare for Life is secondary.

Tricare for Life pays the rest of the claim after Medicare covers its share and pays the rest directly to the provider. Tricare for Life covers most of Medicare’s out-of-pocket expenses, like deductibles and copayments, so you don’t need Medigap coverage.

Not everything’s covered. If you use a Medicare-covered medical treatment not covered by Tricare for Life, such as chiropractic care, Tricare for Life won’t pay anything. Then you’ll have to pay what Medicare doesn’t.

If Tricare for Life covers something Medicare doesn’t, like care outside the U.S., it pays the same as regular Tricare. You’ll have to cover any deductibles and copayments.

Need more information? Check the Defense Health Agency’s Tricare for Life webpage for details on eligibility, enrollment, and coverage.

Do I need Part D if I have Tricare for Life?

No, since Tricare for Life includes prescription medicine coverage through the Tricare pharmacy program.

This coverage is as good or better than Medicare Part D, so you won’t incur a late-enrollment penalty if you have it instead.

Part D pays first if you buy its plan while on Tricare for Life. The Tricare pharmacy program pays second for Tricare-covered drugs.

Remember that to be insured by Tricare for Life, you must pay Medicare Part B premiums ($170.10 in 2022). If you have limited income and assets, you can qualify for a Medicare Savings Program, which helps pay your premiums, deductibles, and copayments.

You might also qualify for the Extra Help Program, which helps pay Part D premiums and copayments if you choose to enroll in it.

Contact Information:
Email: [email protected]
Phone: 8889193252