Medicare Part B and TRICARE Guide 2026 | TRICARE.com

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## Quick answer For most beneficiaries, Medicare Part B and TRICARE work together through a program called **TRICARE For Life (TFL)**. Once you are entitled to Medicare Part A, you **must** enroll in and pay for Medicare Part B to keep your TRICARE coverage, which then acts as a second payer to cover your remaining out-of-pocket costs.

Details

### The Enrollment Requirement When a TRICARE beneficiary becomes eligible for Medicare (usually at age 65), they must have Medicare Part B to maintain TRICARE eligibility. If you fail to enroll in Part B, you will lose your TRICARE coverage entirely.

The only major exception is for **Active Duty Service Members (ADSMs)** and their active duty family members. While on active duty, you do not need Part B to keep TRICARE, but you must enroll in it before the service member retires to avoid a break in coverage or late enrollment penalties.

### How TRICARE For Life Works in 2026 Once you have Part A and Part B, you are automatically transitioned to **TRICARE For Life**. There are no enrollment fees for TFL; your "premium" is simply the monthly Medicare Part B premium.

* **Medicare is Primary:** For services covered by both Medicare and TRICARE, Medicare pays first. * **TRICARE is Secondary:** TRICARE pays the remaining out-of-pocket costs (deductibles and coinsurance) that Medicare leaves behind. * **Zero Out-of-Pocket:** In most cases, if the provider accepts Medicare and TRICARE, your out-of-pocket cost for covered medical services is **$0**.

### Costs and Premiums (2026) While TRICARE For Life has no monthly enrollment fee, you must pay the standard Medicare Part B premium. For 2026, these rates are determined by the Centers for Medicare & Medicaid Services (CMS) and are often deducted from your Social Security check. * **Part B Premiums:** Varies based on income—check Medicare.gov for 2026 IRMAA brackets. * **TRICARE Deductibles:** Most TFL beneficiaries do not pay a TRICARE deductible for Medicare-covered services.

### Regional Management While Medicare handles the primary claims, TRICARE's portion is managed by regional contractors. As of 2026: * **East Region:** Managed by **Humana Military**. * **West Region:** Managed by **TriWest Healthcare Alliance**. * **Pharmacy:** Managed by **Express Scripts**. TFL includes the same robust pharmacy benefit as other TRICARE plans.

### Medicare Advantage vs. TRICARE For Life You can choose to enroll in a Medicare Advantage (Part C) plan. If you do, TRICARE For Life can still be used, but you must coordinate benefits. In this scenario, the Medicare Advantage plan pays first, and TFL pays the remaining copays or coinsurance.

## Who this affects * **Retirees and their Spouses:** This is the primary group; enrollment in Part B at age 65 is mandatory to keep TRICARE. * **Disabled Beneficiaries:** Those under age 65 who receive Social Security Disability Insurance (SSDI) for 24 months must typically enroll in Part B to keep TRICARE. * **Survivors:** Spouses of deceased service members who reach age 65. * **Medal of Honor Recipients:** And their families who are Medicare-eligible. * **Active Duty Families:** Can defer Part B without penalty, but must enroll before the sponsor retires.

## Sources 1. **TRICARE.mil:** TRICARE For Life Overview (https://www.tricare.mil/tfl) 2. **Defense Health Agency (DHA):** Medicare and TRICARE Details (https://health.mil) 3. **Medicare.gov:** Coordination of Benefits with TRICARE (https://www.medicare.gov) 4. **TriWest Healthcare Alliance:** West Region Information (https://www.triwest.com)