Medicare and TRICARE: 2026 Guide to TRICARE For Life | TRICARE.com

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## Quick answer Medicare is the federal health insurance program for people age 65 or older and certain younger people with disabilities. For the military community, Medicare works with TRICARE to provide lifelong coverage (TRICARE For Life), provided you have both Medicare Part A and Part B. In most cases, Medicare acts as the primary payer, and TRICARE acts as the second payer.

## In detail Medicare is divided into several parts, and understanding how they interact with TRICARE is essential for maintaining coverage.

### Medicare Part A (Hospital Insurance) Most people become eligible for Part A at age 65. It covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Most TRICARE beneficiaries receive Part A premium-free based on their or their spouse's work history.

### Medicare Part B (Medical Insurance) Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. **To keep TRICARE coverage after age 65, you must enroll in and pay the monthly premiums for Medicare Part B.** Failure to enroll in Part B results in the loss of all TRICARE eligibility, except for some active-duty family members.

* **2026 Costs:** Medicare Part B premiums are adjusted annually by CMS. Most beneficiaries pay a standard monthly premium (check Medicare.gov for 2026 specifics), though higher-income earners may pay an Income-Related Monthly Adjustment Amount (IRMAA).

### TRICARE For Life (TFL) When you have both Medicare Part A and Part B, you are automatically covered by TRICARE For Life. There are no enrollment fees for TFL. * **How it works:** You visit any Medicare-provider. Medicare pays its share first. The provider files the claim with Medicare, and Medicare "crosses it over" to the TRICARE contractors (Humana Military in the East or TriWest in the West). * **Cost-sharing:** In most cases, Medicare pays 80%, and TRICARE For Life pays the remaining 20%, leaving you with $0 out-of-pocket for covered services.

### Medicare Part D (Prescription Drugs) Because TRICARE includes a robust pharmacy benefit managed by Express Scripts, most TRICARE beneficiaries **do not** need to enroll in Medicare Part D. TRICARE’s pharmacy coverage is considered "creditable coverage," meaning it is at least as good as Medicare's.

### Regional Management (T-5 Contract) As of 2026, the TRICARE regions are managed by: * **East Region:** Humana Military * **West Region:** TriWest Healthcare Alliance (Effective Jan 1, 2025) * **Overseas:** International SOS

## Who this applies to * **Retirees (Age 65+):** Must enroll in Medicare Part A and Part B to remain TRICARE eligible. * **Active Duty Family Members (Age 65+):** May remain in TRICARE Prime or Select without Part B until the sponsor retires, though early enrollment is often recommended to avoid late enrollment penalties. * **Individuals with Disabilities:** Those under 65 who have received Social Security Disability Insurance (SSDI) for 24 months are Medicare-eligible and must have Part B to keep TRICARE. * **End-Stage Renal Disease (ESRD) Patients:** Individuals with kidney failure requiring dialysis or transplant are Medicare-eligible regardless of age.

Common scenarios

### Scenario 1: A retired veteran turning 65 in 2026 John is a retired Army officer. He turns 65 in June 2026. To keep his TRICARE benefits, he signs up for Medicare Part A and Part B during his Initial Enrollment Period. Starting June 1, his TRICARE Select coverage automatically transitions to TRICARE For Life. When he sees his doctor for a covered $200 visit, Medicare pays $160, and TRICARE pays the remaining $40. John pays $0.

### Scenario 2: A retiree with higher income Sarah is a retired Navy nurse with a significant pension and investment income. Because her income exceeds certain thresholds, her 2026 Medicare Part B premium includes an IRMAA surcharge. While she pays more for Part B than the average retiree, her TRICARE For Life coverage remains free of monthly enrollment fees.

### Scenario 3: Living Overseas Robert is a retiree living in Spain. Because Medicare does not provide coverage outside the 50 United States and U.S. Territories, TRICARE For Life acts as his primary payer. He must still pay his Medicare Part B premiums to keep TFL, even though Medicare won't pay for his care in Spain.

## Related terms * **CMS:** The Centers for Medicare & Medicaid Services, the federal agency that runs Medicare. * **Dual Eligible:** A person who qualifies for both Medicare and TRICARE (or Medicaid). * **Creditable Coverage:** Health or drug coverage that is expected to pay on average as much as the standard Medicare plan. * **Initial Enrollment Period (IEP):** The 7-month window around your 65th birthday to sign up for Medicare. * **Crossover Claim:** A medical claim that is automatically sent from Medicare to TRICARE for secondary payment.

## Sources * TRICARE.mil: Medicare [https://www.tricare.mil/medicare] * Medicare.gov: Official U.S. Government Site [https://www.medicare.gov] * Defense Health Agency: TRICARE For Life Handbook [https://www.tricare.mil/publications]