TRICARE For Life Explained: Eligibility, Costs, and Rules

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 deductibles and coinsurance for TRICARE-covered services.

*Note: TRICARE.com is an independent reference site and is not the official TRICARE program. For official policy and enrollment, visit [TRICARE.mil](https://www.tricare.mil).*

## Quick answer TRICARE For Life is a secondary insurance program that pays after Medicare for military retirees and their families. It is automatic for those who have Medicare Part A and Part B, has no separate enrollment fee, and typically reduces your out-of-pocket medical costs to $0 for services covered by both Medicare and TRICARE.

Details

### Eligibility and "Automatic" Enrollment TFL is available worldwide. There is no enrollment form or annual fee for TRICARE For Life; however, you **must** be enrolled in Medicare Part B and pay the monthly Medicare Part B premium to keep your TFL coverage active. If you drop Medicare Part B, you lose your TRICARE eligibility immediately.

In the DEERS system, your status will automatically update to TRICARE For Life once you reach age 65 and Medicare coverage is verified.

### How Billing Works (2026 Rates) Because TRICARE For Life acts as a "wraparound," the billing sequence depends on where you live and what service you receive:

* **Services covered by Medicare and TRICARE:** Medicare pays its share first, and TRICARE pays the remaining balance. Your out-of-pocket cost is usually **$0**. * **Services covered by Medicare but not TRICARE:** Medicare pays its share, and you pay the remaining deductible and coinsurance. * **Services covered by TRICARE but not Medicare (e.g., overseas care):** TRICARE pays as the primary payer. You are responsible for the TRICARE deductible and cost-shares (e.g., for Group A retirees in 2026, the TRICARE deductible varies—check TRICARE.mil for specific 2026 plan year updates). * **Services not covered by either:** You pay 100% of the bill.

### Pharmacy Benefit TFL beneficiaries are covered by the TRICARE Pharmacy Program, managed by **Express Scripts**. You can use Military Pharmacies ($0 copay), TRICARE Pharmacy Home Delivery, or retail network pharmacies.

### Coordination with Other Health Insurance (OHI) If you have a private employer-sponsored health plan in addition to Medicare and TFL, the order of payment is: 1. Other Health Insurance (OHI) 2. Medicare 3. TRICARE For Life

### West vs. East Regions While the administrative contractors differ—**Humana Military** for the East Region and **TriWest Healthcare Alliance** for the West Region (as of the T-5 contract start in 2025)—TFL is managed nationally by the TRICARE Dual Eligible Fiscal Intermediary. Claims for TFL in the U.S. and U.S. Territories are usually processed automatically via Medicare-to-TRICARE "crossover" billing.

## Who this affects * **Retirees:** Retired service members from Active Duty, National Guard, or Reserves who are age 65+. * **Family Members:** Spouses or eligible dependents of retirees who are age 65+. * **Seniors with Disabilities:** Certain beneficiaries under age 65 who qualify for Medicare due to a disability or End-Stage Renal Disease (ESRD). * **Survivors:** Eligible surviving spouses who are entitled to Medicare Part A and B.

## Sources * **TRICARE.mil:** [TRICARE For Life Overview](https://www.tricare.mil/tfl) * **Defense Health Agency (DHA):** [Medicare and TRICARE Coordination](https://health.mil) * **Medicare.gov:** [How Medicare Works with Other Insurance](https://www.medicare.gov) * **Express Scripts:** [TRICARE Pharmacy Program](https://militaryrx.express-scripts.com/)