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

Yes. To continue Tricare benefits after you turn 65, you must enroll in Medicare Part A and Part B. The key is to sign up at least a month before your birthday to receive your Medicare card in the mail before coverage begins.

• Tricare is the health care program for active-duty service members, military retirees and eligible family members.
• Tricare for Life is for those eligible for Tricare who are at least 65 or qualify for Medicare early because of a disability. It’s designed to supplement Medicare, much like Medigap plans do for many of those who sign up for original Medicare and don’t have retiree coverage.

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If you retire from the military and receive Tricare benefits before age 65, your coverage changes to Tricare for Life when you enroll in Medicare. If you don’t enroll in Medicare by 65, your Tricare benefits end the first day of the month you turn 65.

If you don’t sign up within your Medicare initial enrollment period, the three months before and after you turn 65, you may have to pay a late enrollment penalty if you sign up later — unless you have health insurance from a current employer.

How do Tricare and Tricare for Life work?

Tricare has several coverage options depending on whether you’re on active duty or a military retiree. Some types of Tricare contract with hospitals and medical personnel to deliver care at a lower cost than out-of-network services, similar to a health maintenance organization (HMO) or a preferred provider organization (PPO). 

After you retire from the military, Tricare can be your primary coverage or you can use it to supplement coverage from another employer until you turn 65, when Tricare for Life takes over.

Tricare for Life covers Medicare’s deductibles and copayments, provides prescription drug coverage and includes extra benefits such as health care outside the U.S. You can use any provider who accepts Medicare. While you don’t need to submit paperwork, you must sign up for Medicare Part A and Part B to receive Tricare for Life.

If you can’t receive premium-free Part A because neither you nor your spouse has paid at least 40 calendar quarters of Medicare payroll taxes, you’ll stay in Tricare, but you’ll have to take specific steps to do so. Very few fall into this exception because military personnel have had Medicare taxes deducted from their pay since the program started.

Couples may be eligible at different times

As you and your spouse near your 65th birthdays, think about your personal Tricare coverage as an individual policy, like Medicare is, not as a family plan. An older spouse — or a younger spouse who qualifies for early Medicare because of a disability — can receive Tricare for Life benefits after signing up for Medicare Parts A and B. A spouse younger than 65 remains in Tricare. 

You must pay Medicare Part B premiums, which are $174.70 a month in 2024 or more for high earners. However, Tricare for Life has no separate premium.