Tricare For Life vs Medicare
Tricare for Life works with Original Medicare to pay the out-of-pocket costs that Medicare does not cover. It can do the same if you have a Medicare Advantage plan — but it may not work as seamlessly. You must be eligible for Tricare and enrolled in Medicare to qualify for Tricare for Life.
Difference Between Tricare for Life and Original Medicare
Tricare for Life and Original Medicare — Medicare Part A and Part B — are federal health insurance programs. Tricare for Life acts as secondary insurance to Original Medicare for service members and military family members who have Medicare.
Among the chief differences between Tricare for Life and Original Medicare is that Tricare for Life helps pay your out-of-pocket costs — copays and coinsurance — that Original Medicare doesn’t cover.
Medicare is available to everyone in the U.S. who qualifies for it, while Tricare for Life provides Medicare-wraparound coverage for Tricare members who have Medicare Part A and Part B coverage.
There is no monthly premium for Tricare for Life, but you still have to pay the Medicare Part B monthly premium, which in 2022 is $170.10.
To understand the differences, it’s helpful to know the basic purpose of Tricare, Tricare for Life and Medicare.
- Tricare is the federal government’s health care program for active duty service members, active duty family members, members of the National Guard and Reserves and their family members. It is also available to military retiree family members, survivors and certain former spouses worldwide.
- Tricare for Life
- Tricare for Life is health care coverage that’s designed to wrap around Medicare for those Tricare beneficiaries who also have Medicare Part A and Part B. It works regardless of the beneficiary’s age or where they live. It allows you to seek care at any Medicare-participating or nonparticipating provider — or from any military hospital or clinic if space is available.
- Original Medicare is a federal health insurance program available to people who are 65 or older, younger people with certain disabilities and people with end-stage renal disease. Medicare Part A provides hospital insurance, and Medicare Part B provides medical insurance. Private plans — Medicare Advantage, Medicare Part D plans and Medigap — cover these Part A and Part B costs with extra benefits, prescription drugs and out-of-pocket costs.
You should not confuse Tricare and Tricare for Life with VA health care benefits. VA benefits apply to certain former service members who did not receive a dishonorable discharge and who meet certain other criteria.
Tricare for Life vs. Medicare Advantage Plans
Tricare for Life is not a Medicare Advantage plan. Medicare Advantage plans provide primary health care coverage. Tricare for Life helps pay for the costs your Medicare plan does not cover.
Tricare for Life also does not offer any Medicare Advantage plans. But if you are enrolled in Tricare for Life, you can still get a Medicare Advantage plan.
- Both Tricare for Life (TFL) and Medicare Advantage plans have networks of health care providers. TFL may have a larger network for you to choose from, expanding your choices. TFL may also cover copays for a doctor or other provider that your Medicare Advantage plan does not.
- Prescription Drug Coverage
- Both TFL and most Medicare Advantage plans provide prescription drug coverage. If you have Tricare for Life, you may be able to save money by buying a Medicare Advantage plan that does not include prescription drug coverage.
Tricare for Life supplements your Medicare Advantage plan the same way it works to fill coverage gaps if you have Original Medicare. But TFL doesn’t automatically link your payments through a Medicare Advantage plan like it does with Original Medicare. That means if you have a Medicare Advantage plan, you’ll likely have to manually file claims with TFL and wait to be reimbursed.
You can check with Tricare for Life to see if a particular Medicare Advantage plan can be automatically linked to your TFL coverage by calling Tricare at 866-773-0404.
You can also compare Medicare plans to see which may offer the best coverage when combined with Tricare for Life.
Is Tricare for Life Right for You?
Tricare for Life and Medicare work together to cover your health care costs. If the care you receive is covered by both, you may have no out-of-pocket expenses for covered care beyond Medicare Part B monthly premiums.
- You are eligible for Tricare.
- You have Original Medicare — Medicare Part A and Part B.
If you are a retired service member, you and your family are typically eligible for Tricare for Life when you turn 65. Once you are eligible, you are no longer eligible for Tricare Prime — the insurance provided by the federal government to military members and their dependents who are not eligible for Medicare. At that point, you will likely need to enroll in Medicare.
Tricare for Life provides coverage through any health care provider who accepts Medicare. But if you go through Veterans Administration health care providers who opt out of Medicare, you will have to pay more for their services, since those providers are not allowed to bill Medicare.
9 Cited Research Articles
- Tricare. (2021, October 5). Q&A: Tricare for Life Expert Discusses How You Get Coverage. Retrieved from https://newsroom.tricare.mil/Articles/Article/2799855/qa-tricare-for-life-expert-discusses-how-you-get-coverage
- Tricare. (2021, October 4). Tricare 101. Retrieved from https://www.tricare.mil/Plans/New
- Tricare. (2021, October). Tricare and Medicare; Turning Age 65. Retrieved from https://drive.google.com/file/d/1PN2oQGlzM8K0oqTkyh7e9eKv2UZsZmOz/view
- Tricare. (2021, January). Tricare for Life Handbook (Download). Retrieved from https://www.tricare.mil/Plans/HealthPlans/TFL
- Ostrom, S. (2020, November 16). What Tricare for Life Enrollees Should Know About Medicare Advantage Plans.
- West, M. (2020, October 20). Does Tricare for Life Offer Medicare Advantage Plans? Retrieved from https://www.medicalnewstoday.com/articles/tricare-for-life-and-medicare-advantage
- Tricare. (2018, August 5). Tricare for Life. Retrieved from https://www.tricare.mil/Plans/HealthPlans/TFL
- Tricare. (2017, December 19). Becoming Medicare-Eligible. Retrieved from https://tricare.mil/LifeEvents/Medicare
- U.S. Centers for Medicare & Medicaid Services. (n.d.). How Medicare Works With Other Insurance. Retrieved from https://www.medicare.gov/supplements-other-insurance/how-medicare-works-with-other-insurance