Becoming Medicare-Eligible
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QLE? |
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Becoming Medicare-Eligible |
Yes. You have 90 days after you become eligible for Medicare to change your TRICARE health plan. NOTE: Plan options will vary depending on your situation (see below). |
Medicare is a health insurance program for people:
- Age 65 or older
- Under age 65 with certain disabilities. (If you have Medicare due to a disability, you can continue your TRICARE Prime enrollment [if you qualify]. If you do, your Prime enrollment fees are waived. You can also get a refund for any Prime enrollment fees that you paid. Check with your regional contractor for details.)
- With end stage renal disease
- With Lou Gehrig's disease
- Mesothelioma
The Centers for Medicare and Medicaid Services manages Medicare. If eligible, you have the option of using Original Medicare or enrolling in a Medicare Advantage plan.
Original Medicare |
Medicare Advantage (Medicare Part C) |
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Using Medicare and TRICARE Together
If you have Medicare Part A, you must also have Medicare Part B to remain eligible for TRICARE, including prescription drug coverage. Your TRICARE coverage options when entitled to Medicare depend on your age:
Under Age 65 |
Age 65 and Older |
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TRICARE PrimeIf you're under age 65, entitled to Medicare Part A, and have Medicare Part B, you don’t have to disenroll from TRICARE Prime or the US Family Health Plan. TRICARE Prime will waive your individual enrollment fee. Please note: If you have TRICARE Prime or receive coverage from TRICARE For Life, your claims won’t process through the regional contractor.
If you choose not to enroll in TRICARE Prime or US Family Health Plan, you’ll automatically be covered by TRICARE For Life. |
TRICARE For LifeWhen you have Medicare Parts A and B, you automatically receive coverage from TRICARE For Life. There are no enrollment forms or enrollment fees for TRICARE For Life.
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Prescription Drug Coverage
You must have Medicare Part B, unless you qualify for an exception listed above. You can continue to get prescriptions filled with no break in coverage as long as you have Medicare Part B when you first become eligible for Medicare Part A.
Medicare Part D, a prescription drug plan, is available to everyone with Medicare. You don't need Part D to keep TRICARE. If you meet certain income and resource limits, you may qualify for extra help from Medicare to pay Part D premiums. >>Learn More
TRICARE Young Adult is the second payer after Medicare.
If you have Medicare due to a disability, you can continue your TRICARE Prime enrollment (if you qualify). If you do, your Prime enrollment fees are waived. You can also get a refund for any Prime enrollment fees that you paid. Check with your regional contractor for details.
You may still be covered. >>Learn More
Last Updated 12/19/2017