If you’re a military retiree with TRICARE, turning 65 marks an important milestone for maintaining your healthcare coverage. To continue receiving TRICARE benefits, you must enroll in Medicare Parts A and B. Below, we’ll explore why this step is essential, how TRICARE integrates with Medicare, and what steps you need to take to ensure seamless coverage.
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Enrolling in Medicare to keep TRICARE benefits
The Importance of Enrolling at 65
To retain your TRICARE benefits after age 65, enrolling in Medicare Parts A and B is mandatory. Failure to do so will result in the termination of your TRICARE coverage on the first day of the month you turn 65. It’s advisable to enroll at least one month before your birthday to ensure you receive your Medicare card and coverage begins without interruption.
What is TRICARE for life?
TRICARE for Life is such a supplemental health program for TRICARE-eligible persons above 65 or certified as eligible for early Medicare due to disability. It operates like a Medigap plan, covering all Medigap deductibles, co-payments, and other functional benefits that cover some prescription drugs and health care while traveling abroad.
TRICARE for Life is activated as your secondary coverage immediately after you enroll in Medicare Parts A and B; this takes effect automatically and works in conjunction with your Medicare benefit to minimize your out-of-pocket costs.
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Transitioning to TRICARE for life
Before Age 65
If you’re a military retiree under 65, TRICARE can serve as your primary insurance or supplement employer-sponsored coverage. However, this changes when you turn 65 and become eligible for TRICARE for Life.
Medicare Enrollment Period
Your Medicare initial enrollment period spans three months before and after your 65th birthday. Missing this window could result in a late enrollment penalty unless you have qualifying health insurance through a current employer.
How do TRICARE and Medicare work together?
Primary and Secondary Coverage
When you’re enrolled in both TRICARE for Life and Medicare:
- Medicare serves as your primary insurance, paying first for covered services.
- TRICARE for Life acts as secondary coverage, paying Medicare deductibles, copayments, and other eligible expenses.
For services that Medicare covers but TRICARE for Life does not—such as some chiropractic care—you’ll be responsible for the remaining costs. Conversely, TRICARE for Life covers some services not included in Medicare, such as healthcare outside the United States.
Prescription drug coverage
Covered under TRICARE for Life? The TRICARE pharmacy program provides prescription drug coverage recognized as “creditable” coverage, i.e., it satisfies Medicare’s requirements. You do not need to enroll in a different Medicare Part D plan. On purchasing Part D, costs will be settled first by such a plan, and then eligible costs will be incurred under the TRICARE pharmacy program.
What if you’re still working at 65?
An individual and their married partner can now be delaying Medicare enrollment without any penalty due to the ongoing employers’ health insurance. TRICARE will only supplement the original Medicare Parts A and B after such enrollment. When that employer stops its coverage, the person qualifies for a special enrollment period, which allows him to enroll in Medicare within eight months without having to pay any penalties.
Special considerations for couples
Unlike family health plans, TRICARE and TRICARE for Life coverage are individualized. If you and your spouse are approaching 65 at different times, you may have varying coverage statuses. For example:
- The older spouse, or one qualifying for Medicare early due to a disability, can enroll in TRICARE for Life.
- The younger spouse under 65 will remain on TRICARE.
Be mindful of the Medicare Part B premium, which in 2024 starts at $174.70 per month, with higher costs for high-income earners. TRICARE for Life, however, has no separate premium.
Key points to remember
- TRICARE vs. VA Benefits: TRICARE is distinct from VA healthcare benefits, which have different rules for Medicare coordination.
- Premium-Free Part A: If you or your spouse didn’t pay Medicare taxes for at least 40 quarters, you may need to take additional steps to remain in TRICARE.
- Helpful Resources: The Defense Health Agency’s TRICARE for Life page and AARP’s Veterans Health Benefits Navigator provide comprehensive guidance on eligibility, enrollment, and coverage.
By enrolling in Medicare Parts A and B at age 65, you ensure uninterrupted access to TRICARE for Life, preserving the robust healthcare benefits you’ve earned through your military service.
