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

Kimberly Lankford,

AARP

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En español

Published February 22, 2023

/ Updated July 19, 2024

In this story

Enrolling at 65 • How they work • Spouse coverage • Primary vs. secondary • Prescription drugs • Finding help

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.

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.

If you’re still on active duty and your spouse qualifies for Medicare benefits because of a disability, they aren’t required to enroll in Part B to keep Tricare benefits. But your spouse will need to enroll in Medicare before your active duty ends to avoid a break in coverage.

As a military retiree, you can delay signing up for Medicare without penalty if you or your spouse are still working at age 65 and you have health coverage from that employer. But after you reach 65, you won’t have Tricare, which you may have used to supplement your employer’s coverage.

If you or your spouse are still working, you’re eligible for a special enrollment period. You can sign up for Medicare at any time while you’re employed or within eight months of leaving the job or stopping the employer’s insurance.

How does Tricare for Life work with Medicare?

Primary vs. secondary. When you have Tricare for Life and Medicare, Medicare is the primary coverage that gets billed first. Tricare for Life is secondary.

After Medicare pays its share, the rest of the claim is sent to Tricare for Life to cover, which typically includes Medicare’s out-of-pocket costs, like deductibles and copayments. This is why you won’t need a Medigap policy.

Not everything is covered. If you use a medical service that Medicare covers but Tricare for Life doesn’t, like some chiropractic care, Tricare for Life won’t pay anything toward the bill. In that case, you will have to pay what Medicare doesn’t.

If Tricare for Life covers something that Medicare doesn’t, such as health care outside the U.S., Tricare for Life pays the same rate as regular Tricare. You pay any deductibles and copayments.

Do I need a Part D prescription plan if I have Tricare for Life?

When you’re enrolled in Tricare for Life, you have prescription drug coverage under the Tricare pharmacy program, which is considered “creditable coverage.” That means you won’t have to pay a late enrollment penalty if you have that coverage instead of Part D.

If you purchase a Part D prescription drug plan while covered by Tricare for Life, the Part D policy pays first. The Tricare pharmacy program pays second for Tricare-covered medicine.

Keep in mind

Tricare is different from the U.S. Department of Veterans Affairs (VA) health care benefits, which have different rules for coordinating with Medicare. For more information about the health benefits available for veterans, active-duty service members and military families, see AARP’s Veterans Health Benefits Navigator.

Want more details? See the federal Defense Health Agency’s Tricare for Life page, which includes a link to the Tricare for Life handbook, for more information about eligibility, enrollment and coverage.

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Kimberly Lankford is a contributing writer who covers Medicare and personal finance. She wrote about insurance, Medicare, retirement and taxes for more than 20 years at Kiplinger’s Personal Finance and has written for The Washington Post and Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers and the New York State Society of CPAs’ excellence in financial journalism award for her guide to Medicare.