What is TRICARE For Life?

 

TRICARE For Life is Medicare-wraparound coverage for TRICARE-eligible beneficiaries (doesn’t’ include active duty service members and active duty family members) who have Medicare Part A and Part B. You don’t need to enroll; coverage is automatic once you have Medicare Part A and Part B. TRICARE For Life is available worldwide. To learn more, visit the TRICARE For Life page. 

Costs:

There are no enrollment fees but you must pay the Medicare Part B monthly premium. See table below for other costs.

A Service Is	Medicare Pays	TRICARE Pays	You Pay
Covered by Medicare and TRICARE	Medicare-approved amount	Remaining Amount	$0
Covered by only Medicare	Medicare-approved amount	$0	Medicare deductibles and cost shares
Covered by only TRICARE or Overseas care	$0	TRICARE-allowable chargeThe maximum amount TRICARE pays for each procedure or service.  This is tied by law to Medicare's allowable charges.	TRICARE deductibles and cost shares
Not covered by Medicare or TRICARE	$0	$0	100% of the billed charges

 

Providers:

In the U.S. and U.S. Territories, you may get care:

• From any Medicare-certified provider. Find a Medicare Provider. 
• At a military hospital or clinic if space is available. 

Note: TRICARE processes your claim after Medicare. If you don't have other health insuranceHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "other health insurance.", your doctor files your claim with Medicare. Medicare processes your claim and automatically forwards it to TRICARE For Life. 

Overseas, you may get care:

• From any overseas civilian provider. 
• At a military hospital or clinic if space is available.

Note: TRICARE pays first for covered services. You need to file your claims with the overseas contractor. To learn more, visit the Filing Claims Overseas page. 

 

Referrals and Authorizations:

In the U.S. and U.S. Territories, you must follow Medicare’s rules.

Overseas, you usually don’t need a referral for primary and specialty careSpecialized medical/surgical diagnosis, treatment, or services a primary care provider isn’t qualified to provide. appointments. You need a referral for Applied Behavioral Analysis. You need preauthorization for some procedures and treatments. For example, you may see a pain specialist without a referral, but you would still need approval for some pain treatments. 

Covered Services:

In the U.S. and U.S. Territories, visit Medicare’s Coverage page to find out if Medicare covers your service.

Overseas, visit the Covered Services page to find out if TRICARE covers your service.

 

Pharmacy Benefits:

Included with the TRICARE Pharmacy Program. To learn more, visit the Pharmacy page.

 

Dental Benefits:

• Not included.
• You may have the option to enroll in dental coverage through the Federal Employees Dental and Vision Insurance Program (FEDVIP). To learn more, visit BENEFEDS.com.

 

Vision benefits:

• Not included.
• You may have the option to enroll in vision coverage through the Federal Employees Dental and Vision Insurance Program (FEDVIP). To learn more, visit BENEFEDS.com.