TRICARE vs Medicare: 2026 Comparison Guide | TRICARE.com

*Disclaimer: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense or the official TRICARE program. For official policy and enrollment, visit TRICARE.mil.*

If you are a member of the military community, you don't always have to choose between TRICARE and Medicare—often, they work together. However, understanding how they compare is vital for retirees and those nearing age 65.

## Bottom line * **Lowest Cost:** **TRICARE** (specifically for active duty and retirees under 65) generally has much lower premiums and out-of-pocket caps than Medicare. * **Most Flexibility:** **Medicare** (with a Supplement/Medigap plan) allows you to see almost any doctor in the U.S. who accepts Medicare, whereas TRICARE Prime restricts you to a specific network. * **Best for Families:** **TRICARE** is designed for whole-family coverage; Medicare is an individual benefit only. * **Best for Retirees 65+:** **TRICARE For Life (TFL)** is the winner, as it acts as a wraparound supplement to Medicare, resulting in near-zero out-of-pocket costs for covered services.

Side-by-side comparison (2026 Rates)

This table compares **TRICARE Select (Group A Retirees)** with **Original Medicare (Parts A & B)**. *Note: Most TRICARE beneficiaries must transition to Medicare at age 65.*

| Feature | TRICARE Select (Retirees) | Original Medicare (Parts A & B) | | :--- | :--- | :--- | | **Eligibility** | Military retirees and families | Age 65+, or specific disabilities | | **Enrollment Fee** | ~$385/yr (Individual) | Part B Premium: ~$185+/mo (Income-based) | | **Annual Deductible** | ~$190 per individual | Part B: ~$250+; Part A: ~$1,700/benefit period | | **Primary Care Copay** | $37 (In-network) | 20% of Medicare-approved amount | | **Specialist Copay** | $50 (In-network) | 20% of Medicare-approved amount | | **ER Copay** | $153 | 20% of Medicare-approved amount | | **Pharmacy Tier 1** | $16 (30-day retail) | Varies by Part D plan | | **Referrals Required** | No (for Select) | No | | **Network Restrictions** | TRICARE East (Humana) / West (TriWest) | Any provider accepting Medicare | | **Catastrophic Cap** | $4,392/yr (2026) | **No cap** (unless using Medigap/Advantage) |

When to choose each

### Choose TRICARE if... You are an active-duty family member or a retiree under age 65. TRICARE offers integrated pharmacy benefits through Express Scripts and a hard "catastrophic cap" that Medicare lacks. It is significantly more affordable for families because one enrollment fee covers the household, whereas Medicare requires each individual to pay their own premiums.

### Choose Medicare if... You have reached age 65. At this milestone, Medicare becomes mandatory to remain eligible for TRICARE (this combined coverage is called **TRICARE For Life**). Medicare is also the better choice if you want the freedom to see providers nationwide without the geographic constraints of TRICARE Prime's Military Treatment Facility (MTF) clusters.

## Switching between them You cannot simply "switch" from TRICARE to Medicare by choice early on; Medicare eligibility is triggered by age (65) or specific Social Security Disability triggers.

* **The Age 65 Transition:** This is the most common switch. You must enroll in Medicare Part B to keep TRICARE. Once Medicare is active, you are automatically moved to TRICARE For Life (TFL). * **Open Season:** TRICARE has an annual Open Season (usually Nov-Dec) for plan changes. Medicare has its own General Enrollment Period (Jan 1–Mar 31) and Annual Enrollment Period (Oct 15–Dec 7). * **Qualifying Life Events (QLE):** Moving, marriage, or retirement allows you to change TRICARE plans outside of Open Season. Medicare allows "Special Enrollment Periods" if you lose employer coverage.

## Sources * **TRICARE.mil:** [Retiring and Medicare Eligibility](https://www.tricare.mil/medicare) * **Medicare.gov:** [Medicare costs at a glance](https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/working-past-65) * **Defense Health Agency:** [T-5 Contract Information (TriWest)](https://www.triwest.com) * **Express Scripts:** [TRICARE Pharmacy Home Delivery](https://www.express-scripts.com/tricare)