Medicare & TRICARE for Life: Your Healthcare Guide at 65
As a retired veteran nearing age 65, you’re likely considering how your healthcare benefits, including Medicare and TRICARE For Life (TFL), will work together. At the Retired Military Benefit Association, we’re here to guide you through this critical transition. Turning 65 brings unique healthcare considerations, and understanding the relationship between Medicare and TRICARE For Life can empower you to make informed decisions and avoid out-of-pocket costs.
This guide is designed to answer your questions about TFL eligibility, Medicare Parts A, B, C, and D, and how these benefits coordinate to give you comprehensive coverage.
What is TRICARE For Life (TFL) and How Does It Work with Medicare?
TRICARE For Life serves as Medicare wraparound coverage for eligible retired veterans and their families. This means TFL works alongside Medicare to cover costs that Medicare doesn’t, significantly reducing your out-of-pocket expenses. According to TRICARE For Life Program Manager Anne E. Breslin, “You’ll pay nothing out of pocket when the services you receive are a benefit of both Medicare and TRICARE.”
For many veterans, this wraparound coverage provides peace of mind, as it ensures you have robust healthcare coverage across a wide range of services.
Eligibility for TRICARE For Life and Medicare at Age 65
As you approach age 65, Medicare eligibility becomes a key consideration. Most individuals qualify for Medicare at age 65; however, some may be eligible sooner due to disability or certain health conditions.
To be eligible for TFL, you must:
Be a retired military member or eligible family member
Be eligible for TRICARE and enrolled in Medicare Part A (hospital insurance) and Medicare Part B (medical insurance)
Family members who are not eligible for Medicare remain covered under TRICARE Prime or TRICARE Select, so TFL is an individual benefit based on your specific Medicare enrollment.
How to Enroll in Medicare and Ensure TRICARE For Life Coverage
Enrolling in Medicare Parts A and B is essential to activate your TRICARE For Life benefits. This process begins through the Social Security Administration, either online or by setting up an appointment. We recommend enrolling at least two months before you turn 65 to avoid any gap in your TRICARE coverage.
Once you’re enrolled in Medicare Parts A and B, your TFL coverage will begin automatically—no additional forms or fees are required. Our team at the Retired Military Benefit Association is here to guide you through the enrollment process and answer questions along the way.
Jim’s Journey: How One Veteran Learned the Value of Medicare and TRICARE For Life Working Together
Picture Jim, a retired veteran turning 65, who had always relied on TRICARE for his healthcare needs. Confident he didn’t need Medicare, he dismissed it as unnecessary and balked at the thought of paying a monthly premium for Part B. But after a friend urged him to look into it, Jim discovered that TRICARE For Life would only activate if he enrolled in Medicare Parts A and B. Without it, he’d actually lose out on his TRICARE benefits altogether.
When Jim finally enrolled, he was relieved to find that TRICARE For Life provided wraparound coverage for Medicare, taking care of costs that Medicare doesn’t cover and keeping his out-of-pocket expenses low. This wasn’t just an extra step—it was essential to his peace of mind and financial security.
If you’re approaching 65, take a page from Jim’s book: don’t leave your coverage to chance. By planning early and understanding how Medicare and TRICARE For Life work together, you can avoid gaps in coverage and step confidently into this next phase of life. Let us at the Retired Military Benefit Association guide you through this transition so you can enjoy your well-earned benefits fully.
Breaking Down Medicare Parts for Retired Veterans
For many veterans, understanding the different parts of Medicare is a key step in maximizing benefits and reducing unnecessary costs. Here’s a summary of each part and how it applies to your TFL benefits:
Medicare Part A (Hospital Insurance)
Medicare Part A covers hospital inpatient care, skilled nursing facilities, hospice, and some home health services. Most people qualify for premium-free Part A if they or their spouse paid Social Security taxes for at least 10 years. If not, you may still be eligible based on a spouse’s work history.
Medicare Part B (Medical Insurance)
Medicare Part B covers outpatient care, doctor visits, preventive care, and medical equipment. You must enroll in Part B to receive TRICARE For Life, and there is a monthly premium based on your income. Part B is essential because, without it, TFL won’t activate, and you’ll lose your TRICARE benefits.
Medicare Part C (Medicare Advantage)
Part C, also known as Medicare Advantage, is optional. These plans, offered by private companies, include all the benefits of Parts A and B, and often additional services like dental and vision. However, enrolling in Part C is not necessary to activate TRICARE For Life, and you may face network restrictions and copayments if you choose a Medicare Advantage plan.
Medicare Part D (Prescription Drug Coverage)
Part D covers prescription drugs and is also optional for TFL beneficiaries. With TFL, you already have access to the TRICARE Pharmacy Program, which provides prescription coverage without additional premiums. However, if you decide to enroll in Part D, know that it will involve a separate premium, and your prescriptions must be filled within the Part D plan’s network.
Coordinating Medicare and TRICARE For Life: Who Pays First?
For eligible services covered by both Medicare and TRICARE, Medicare pays first, and TRICARE covers the remaining costs. This coordination can mean significant savings, as you’ll often have little to no out-of-pocket expenses for services that both plans cover. However, TRICARE may cover some services that Medicare does not, so understanding what each plan covers can help you avoid unexpected expenses.
Before receiving healthcare services, it’s wise to verify if Medicare and TRICARE both cover them. This way, you won’t be caught off guard by costs that one or both plans might not cover.
What if You Have Other Health Insurance?
If you have additional health insurance (OHI) through an employer or spouse, TRICARE For Life will coordinate with both Medicare and your OHI. In this case, Medicare generally pays first, then your other health insurance, and TRICARE For Life pays last. This setup is especially useful if you or your spouse are still working and have employer-sponsored insurance, as it can further reduce your out-of-pocket expenses.
For specific guidelines on how TFL works with other health insurance, check the TRICARE for Life Handbook or reach out to our team for personalized assistance.
FAQs for Retired Veterans Turning 65
Q: Do I need Medicare if I have TRICARE For Life?
A: Yes. To activate TRICARE For Life, you must be enrolled in both Medicare Parts A and B.
Q: Will TRICARE For Life cover everything Medicare doesn’t?
A: TRICARE acts as a secondary payer after Medicare, covering costs not paid by Medicare for eligible services. However, some services covered by TRICARE may not be covered by Medicare, so it’s essential to check each plan’s coverage details.
Q: Should I enroll in Medicare Part C or Part D?
A: Medicare Parts C (Advantage) and D (prescription drug coverage) are optional. Most TFL beneficiaries find the TRICARE Pharmacy Program sufficient for prescriptions, and Medicare Part C is not needed to activate TRICARE For Life.
Q: How do I avoid a gap in TRICARE coverage?
A: Enroll in Medicare Parts A and B at least two months before your 65th birthday to avoid any lapse in TRICARE coverage.
Final Steps: Preparing for a Smooth Transition to Medicare
As you approach age 65, remember that the Retired Military Benefit Association is here to support you every step of the way. Here’s a recap to help you ensure a smooth transition:
Start Early: Begin planning around age 64 to allow plenty of time to understand Medicare options and requirements.
Enroll in Medicare Parts A and B: Sign up at least two months before you turn 65.
Verify Coverage Details: Review Medicare and TRICARE’s coverage details to know what’s covered and who pays first.
Keep DEERS Updated: Ensure your contact information is current in the Defense Enrollment Eligibility Reporting System (DEERS).
Navigating Medicare and TRICARE For Life doesn’t have to be overwhelming. By starting early and leveraging the resources at the Retired Military Benefit Association, you can make this transition confidently and avoid any gaps in your healthcare coverage. For personalized guidance, reach out to us—we’re here to help you maximize your benefits and enter this new stage with peace of mind.
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