What is TRICARE For Life? | Eligibility & 2026 Rates | TRICARE.com

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## Quick answer TRICARE For Life (TFL) is Medicare-wraparound coverage for military retirees and their eligible dependents who are entitled to Medicare Part A and Part B. It acts as a secondary payer to Medicare, covering most out-of-pocket costs like coinsurance and deductibles, effectively serving as a built-in "Medigap" plan for the military enterprise.

Details

TRICARE For Life is an entitlement program that requires no separate enrollment fee. However, to remain eligible, beneficiaries must be enrolled in and pay monthly premiums for **Medicare Part B**.

### How It Works: The "Secondary Payer" Model When you seek care from a provider that accepts Medicare, the billing process typically follows this order: 1. **Medicare pays first:** Medicare pays its share of the bill (usually 80% for Part B services). 2. **TRICARE pays second:** TFL pays the remaining "patient responsibility" (the 20% coinsurance) and the Medicare deductible for TRICARE-covered services. 3. **You pay $0:** In most cases where a service is covered by both Medicare and TRICARE, the beneficiary has no out-of-pocket cost.

### Coverage and Costs (2026 Rates) * **Enrollment Fees:** There is no annual enrollment fee for TFL. * **Catastrophic Cap:** For 2026, the catastrophic cap for retirees (Group A) is generally $4,310, though TFL users rarely hit this because TFL covers the gaps Medicare leaves behind. * **Pharmacy:** TFL includes the TRICARE Pharmacy Home Delivery benefit and retail pharmacy access via Express Scripts. In 2026, a 90-day supply of generic maintenance medication via mail order is $16.

### Providers and Regions Unlike TRICARE Prime or Select, TFL does not have a "network." You can see any provider that accepts Medicare. * **East Region:** Managed by **Humana Military**. * **West Region:** Managed by **TriWest Healthcare Alliance** (as of the T-5 contract transition). * **Overseas:** Since Medicare does not pay for care outside the U.S. and its territories, TFL becomes the *primary* payer for retirees living abroad. In these cases, you will typically pay the TRICARE Select deductible and cost-shares.

### Critical Requirement: Medicare Part B If you are age 65 or older and eligible for Medicare Part A, you **must** have Medicare Part B to keep TRICARE. If you drop Part B, you lose TRICARE coverage immediately. The only major exception is for active duty service members and their spouses, who may delay Part B enrollment until the service member retires.

## Who this affects * **Retirees:** Retired service members of the Active or Reserve components (after age 60 for most Reservists). * **Family Members:** Spouses and certain former spouses of retirees who are Medicare-eligible. * **Survivors:** Surivived spouses of deceased service members. * **Medically Retired:** Individuals retired for disability who become Medicare-eligible regardless of age.

## Sources * **TRICARE.mil:** [TRICARE For Life Overview](https://www.tricare.mil/tfl) * **Defense Health Agency (DHA):** [Medicare and TRICARE](https://www.tricare.mil/medicare) * **TriWest Healthcare Alliance:** [West Region Beneficiary Portal](https://www.triwest.com) * **Express Scripts:** [TRICARE Pharmacy Benefits](https://militaryrx.express-scripts.com/)