The rule
TRICARE For Life is the TRICARE coverage for people who are entitled to Medicare Part A, have Part B, and are TRICARE-eligible, regardless of age or where they live. TRICARE says coverage is automatic once you have both parts, starts the first day both are in effect, and requires you to pay Part B premiums. If you have Part A but drop or never take Part B, you generally lose TRICARE eligibility, and without Part B you can only fill prescriptions at military pharmacies. The only standing exception TRICARE lists is for people who turned 65 before April 1, 2001; there is also the active-duty exception below.
The active-duty exception
If the sponsor is on active duty, active duty service members and active duty family members who become entitled to Part A don't need Part B to keep TRICARE. But they must have Part B in place before the sponsor's active duty ends to keep TRICARE without a break. Medicare has a special enrollment period that lets them sign up for Part B without a penalty while the sponsor is on active duty or within the first eight months of the sponsor's retirement. People entitled to Medicare because of end-stage renal disease don't get that special enrollment period, so TRICARE encourages them to keep Part B when first eligible.
For Washington military retirees
Washington has a large military retiree community around Joint Base Lewis-McChord in Pierce County, the Navy bases on Kitsap Peninsula and Whidbey Island, and Fairchild Air Force Base near Spokane. With TFL, you can see any provider who accepts Medicare, anywhere in Washington. You can get care at military hospitals and clinics, such as the medical center at Joint Base Lewis-McChord, only when space is available, so most TFL users rely on civilian Medicare providers. When you travel or live overseas, TRICARE pays first, and you must still keep Part B to stay eligible.
TFL generally covers the Medicare deductibles and coinsurance for services both programs cover. You'd pay out of pocket for services Medicare covers but TRICARE doesn't (Medicare's cost sharing), for services only TRICARE covers (TRICARE's deductible and cost shares), and for anything neither covers.
Other Medicare choices
You can join a Medicare Advantage plan or a Part D plan while keeping TFL, but think about how the pieces fit. TRICARE pharmacy coverage is creditable, so a separate Part D plan isn't required. If you join a Medicare plan, ask how it coordinates with TFL before you enroll. A licensed insurance agent with Benefits Life can explain how Medicare plans would work with TFL, at no cost to you: (206) SENIORS (206-736-4677), TTY 711.
Get help
For TRICARE eligibility and TFL questions, go to tricare.mil or contact the TFL claims contractor listed there. For Part B enrollment and premiums, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). See also TRICARE For Life in Washington.
Related questions
Can I use VA health care and Medicare in Washington?
How VA care fits with Medicare.
When does Medicare start?
So TFL starts on time.
Does Medicare work in Canada?
Coverage when you cross the border.
Sources
- TRICARE — TRICARE For Life
- TRICARE — Medicare-eligible beneficiaries (Part B requirement)
- TRICARE — Active duty family members with Medicare
- TRICARE — Life events: Medicare and active duty family members (special enrollment period)
- Medicare.gov — Who pays first?
Frequently asked questions
Is there any exception to the Part B rule?
Yes, while the sponsor is on active duty. Active duty service members and their family members who have Part A don't need Part B to keep TRICARE. They must have Part B before the sponsor retires to avoid a break, and they can sign up without a penalty during a special enrollment period while the sponsor is on active duty or within the first eight months of the sponsor's retirement.
Do I have to enroll in TRICARE For Life?
No. TFL coverage starts automatically on the first day you have both Part A and Part B. Your Medicare card and uniformed services ID card are your proof of coverage. Keep your information current in DEERS.
Who pays first?
In the U.S., Medicare pays first and TFL pays second. For services both cover, you generally have no out-of-pocket costs. If you have employer coverage from current work, that plan pays first, then Medicare, then TRICARE.
Do I need a Medigap policy or a Part D plan with TFL?
Usually not. TFL generally pays what's left after Medicare for services both cover, so a Medigap policy would mostly duplicate it. TRICARE says its pharmacy benefit is creditable prescription drug coverage, so you don't need Part D for drug coverage and won't pay a Part D penalty if you join a drug plan later.
Medicare in your Washington county
Plans, local agents and help, county by county: Adams · Asotin · Benton · Chelan · Clallam · Clark · Columbia · Cowlitz · Douglas · Ferry · Franklin · Garfield · Grant · Grays Harbor · Island · Jefferson · King · Kitsap · Kittitas · Klickitat · Lewis · Lincoln · Mason · Okanogan · Pacific · Pend Oreille · Pierce · San Juan · Skagit · Skamania · Snohomish · Spokane · Stevens · Thurston · Wahkiakum · Walla Walla · Whatcom · Whitman · Yakima
