TRICARE for Life & Medicare: Understanding How These Benefits Work Together for Veterans

If you’re a military retiree approaching 65 or already enrolled in Medicare, understanding how TRICARE for Life coordinates with Medicare is essential for maximizing your earned benefits. Many veterans don’t fully understand this relationship, and the confusion can lead to missed opportunities or costly mistakes.

I’m Chris Duncan, founder of Veterans Advantage Financial™. With nearly 20 years of Medicare experience, my team and I work exclusively with veterans. Throughout my career, I’ve helped thousands of military retirees understand how their TRICARE for Life benefits integrate with Medicare, including helping my own father navigate this system as an 81-year-old Vietnam-era veteran.

In this guide, we’ll explain:

• How TRICARE for Life and Medicare work together
• Why you must have both Medicare Parts A and B
• What Medicare options exist for military retirees
• Common misconceptions about coordination of benefits
• How to avoid penalties and maximize your coverage

Understanding TRICARE for Life & Medicare

TRICARE for Life (TFL) is premium-free health coverage for military retirees aged 65 and over, Medal of Honor recipients, and their eligible family members. It’s one of the most valuable benefits you’ve earned through your military service. However, TFL works as wraparound coverage to Medicare, not as a standalone health plan.

According to TRICARE’s official website, “To be eligible for TRICARE For Life, you must have Medicare Part A and Medicare Part B” (Source: TRICARE.mil). This isn’t optional. Federal law requires both parts to maintain your TFL benefits.

How the Coordination Works

When you have both Medicare and TRICARE for Life:

Medicare pays first: Medicare processes your claim and pays its portion according to standard Medicare rules.

TRICARE for Life pays second: TFL then covers most of what Medicare doesn’t pay, including deductibles, copays, and coinsurance for TRICARE-covered services.

You typically pay little to nothing: This coordination usually results in minimal out-of-pocket costs for covered services.

This system provides comprehensive coverage that protects you from the high out-of-pocket costs that many Medicare beneficiaries face.

Why You Must Enroll in Medicare Part B

Many military retirees mistakenly believe they can skip Medicare Part B and keep TRICARE for Life. This is incorrect and can result in losing TFL entirely.

The Part B Requirement

Medicare Part B costs $185 monthly in 2025, with projections of $206.50 for 2026 (Source: Medicare.gov). While this seems like an additional expense, it’s mandatory to maintain your TRICARE for Life benefits.

Without Part B:

• You lose TRICARE for Life completely
• You cannot re-enroll in TFL later
• You face lifetime Medicare penalties if you enroll in Part B later
• You lose access to nationwide coverage outside military treatment facilities

Understanding the 10 Percent Penalty

If you delay Medicare Part B enrollment past your Initial Enrollment Period without creditable coverage, you face a 10 percent penalty for every 12-month period you wait. This penalty lasts for life and grows as Part B premiums increase (Source: Medicare.gov).

Critical fact: TRICARE for Life is NOT creditable coverage for Medicare Part B. You cannot use TFL to avoid the Part B penalty.

Medicare Options for Military Retirees with TRICARE for Life

Once you’re enrolled in Medicare Parts A and B, you have choices about how you receive your Medicare benefits. Understanding these options helps you make informed decisions about your healthcare coverage.

Original Medicare with TRICARE for Life

This is the traditional approach where:

• You keep Original Medicare (Parts A and B)
• TRICARE for Life acts as your wraparound coverage
• You can see any provider who accepts Medicare nationwide
• Most out-of-pocket costs are covered by TFL

Medicare Options from Private Companies

Some military retirees choose Medicare options from private companies that contract with Medicare (also known as Medicare Advantage or Part C). These options can work with TRICARE for Life.

According to TRICARE’s official guidance: “If you enroll in a Medicare Advantage Plan, you still have Medicare. Medicare is still your primary coverage, and TRICARE For Life is the second payer for TRICARE-covered services” (Source: TRICARE.mil).

What These Options May Include

Options from private companies that contract with Medicare vary by county, but may include:

• Different cost structures for how you pay for Medicare coverage
• Additional benefits not covered by Original Medicare or TRICARE
• Various network configurations (PPO, HMO, etc.)
• Prescription drug coverage integrated into the plan

Over 90 percent of our veteran clients choose PPO options that provide nationwide provider access (Veterans Advantage Financial internal data).

Common Misconceptions About TRICARE for Life and Medicare

Misconception 1: “I Don’t Need Medicare Because I Have TFL”

Reality: You must have Medicare Parts A and B to keep TRICARE for Life. They work together, not separately.

Misconception 2: “Medicare Options Will Interfere with My TFL Benefits”

Reality: TRICARE for Life continues to work as wraparound coverage regardless of which Medicare option you choose. Your TFL benefits don’t change.

Misconception 3: “I Should Buy a Medigap Plan with TRICARE for Life”

Reality: This is unnecessary and wasteful. TRICARE for Life already provides comprehensive wraparound coverage. Buying Medigap means paying for duplicate coverage you don’t need. Many military retirees waste thousands annually on Medigap policies when TFL already covers Medicare gaps.

Misconception 4: “VA Coverage Counts as Creditable Coverage”

Reality: VA coverage is NOT creditable coverage for Medicare Part B. Even if you have VA healthcare, you still need Medicare Part B to avoid penalties and keep TRICARE for Life.

How to Enroll in Medicare with TRICARE for Life

Automatic Enrollment

If you’re already receiving Social Security benefits when you turn 65, you’ll be automatically enrolled in Medicare Parts A and B. You’ll receive your Medicare card in the mail approximately three months before your 65th birthday.

Manual Enrollment

If you’re not receiving Social Security, you must enroll in Medicare during your Initial Enrollment Period: the three months before your 65th birthday month, your birthday month, and the three months after.

You can enroll:

• Online at SSA.gov
• By phone at 1-800-772-1213
• In person at your local Social Security office

For detailed enrollment guidance, visit our Medicare forms page to download Form SSA-40B.

Updating DEERS

Once you enroll in Medicare, the Defense Enrollment Eligibility Reporting System (DEERS) automatically updates to activate your TRICARE for Life. You should verify your DEERS information is current at MilConnect.

Real-World Example: How This Works in Practice

Let me share an example of how TRICARE for Life and Medicare coordination works in practice.

A retired Navy officer needed a hip replacement. The VA had a six-month wait for the procedure, but his pain made it difficult to work. Here’s how the coordination worked:

• He chose a civilian orthopedic surgeon who accepts Medicare
• The provider billed Medicare first
• Medicare paid its portion according to standard rules
• TRICARE for Life covered the remaining deductibles and copays
• His out-of-pocket cost was minimal

This example demonstrates why both Medicare and TRICARE for Life are valuable. Medicare provides nationwide access to providers and timely care, while TFL covers the costs Medicare doesn’t pay.

My own father, Wallace Duncan, is an 81-year-old Vietnam-era veteran who uses Medicare options that work well with his VA benefits. Every military retiree’s situation is different, which is why understanding how these benefits coordinate is so important.

What About IRMAA Surcharges?

Income Related Monthly Adjustment Amounts (IRMAA) are additional charges for Medicare beneficiaries with higher incomes. These surcharges are based on your income from two years prior.

If your 2023 income exceeded $106,000 (individual) or $212,000 (married filing jointly), you’re paying IRMAA surcharges in 2025 (Source: Medicare.gov).

You Can Appeal IRMAA

If your income has dropped due to retirement, divorce, death of spouse, or other life-changing events, you can appeal using Form SSA-44. Many veterans successfully reduce or eliminate IRMAA surcharges through appeals.

Special Considerations for Military Retirees

Flexibility with Medicare Options

Military retirees with TRICARE for Life have a unique advantage: you can disenroll from Medicare options at any time during the year and return to Original Medicare with TFL (Source: TRICARE.mil). Most Medicare beneficiaries can only change during specific enrollment periods.

Access to Military Treatment Facilities

Enrolling in Medicare and TRICARE for Life doesn’t change your access to military treatment facilities. You can continue using MTFs on a space-available basis, though you’ll typically be a lower priority than active-duty service members.

Prescription Drug Coverage

TRICARE for Life includes prescription drug coverage, so you’re not required to enroll in Medicare Part D. However, some military retirees choose Medicare options that include prescription coverage for additional benefits or cost management strategies.

What Military Retirees Need to Know About Earned Benefits

You’ve contributed to Medicare through FICA taxes your entire working life. The typical person earning $50,000 annually contributes about $58,000 to Medicare over their career. If you made more, you paid more.

Understanding what Medicare options exist in your county helps you make the most of these contributions. Options vary significantly by location, so what’s available to one veteran may not be available to another.

Common Mistakes Military Retirees Make

Mistake 1: Delaying Medicare Part B

Some military retirees delay Part B thinking TFL is enough. This results in losing TFL and facing lifetime penalties.

Mistake 2: Buying Unnecessary Medigap Coverage

TRICARE for Life already provides wraparound coverage. Purchasing Medigap is paying for duplicate benefits.

Mistake 3: Not Reviewing Options Annually

Medicare options change every year. What’s available in your county can improve significantly, but you won’t know unless you review during Annual Enrollment Period (October 15 through December 7).

Mistake 4: Not Appealing IRMAA Surcharges

Many retired military members qualify for IRMAA appeals but never file them, paying unnecessary surcharges.

For more details on these and other mistakes, read our comprehensive guide on common Medicare mistakes veterans make.

How We Help Military Retirees Navigate This System

At Veterans Advantage Financial™, we work exclusively with veterans. We understand how TRICARE for Life integrates with Medicare because we focus solely on helping military retirees and their families.

Medicare rules enable us to provide our services completely free to veterans. You pay the same price whether you work with us or go directly to insurance companies. The difference? You get specialists who understand military benefits and can explain your options without pushing any particular choice.

What Makes Our Approach Different

We don’t just understand Medicare. We understand how Medicare works with:

• TRICARE for Life
• VA healthcare benefits
• Service-connected disabilities
• Military retirement pay
• Survivor benefits

This comprehensive understanding helps us guide military retirees through decisions that generic Medicare advisors often mishandle.

Your Next Steps

Whether you’re approaching 65 or already enrolled in Medicare, understanding how TRICARE for Life coordinates with Medicare helps you make informed decisions about your healthcare coverage.

If You’re Approaching 65

Contact us six months before your 65th birthday. This gives us time to:

• Explain your enrollment timeline
• Help you avoid penalties
• Review what options exist in your county
• Answer questions about coordination of benefits

If You’re Already on Medicare

Many military retirees enrolled in Medicare without understanding all their options. An annual review ensures you’re making the most of your benefits, especially as options change each year.

Additional Resources

For more information about Medicare and veteran benefits:

• Check our Veterans Medicare FAQ for answers to common questions
• Download important forms from our Medicare forms page
• Review our guide on VA Priority Groups to understand your VA benefits

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Important Disclaimers: We don’t offer every option available in your area. Any information we provide is limited to those options we do offer. Options aren’t available in all areas. Enrollment depends on the option’s contract renewal. For accommodation of persons with special needs at meetings, call 888-960-8387 (VETS).

Christopher Duncan is the founder of Veterans Advantage Financial™ and holds credentials as a Certified Medicare Insurance Planner™ and Retirement Income Certified Professional® with nearly 20 years of Medicare experience. He works exclusively with veterans to help them understand how Medicare coordinates with their military benefits. Connect with us on YouTube or Facebook for more veteran-specific Medicare guidance.