TRICARE For Life
TRICARE For Life (TFL) is Medicare-wraparound coverage if you are TRICARE-eligible and have Medicare Part A and B, regardless of age or place of residence. Coverage is only for those with Medicare and who are TRICARE-eligible. Coverage doesn’t extend to family members.
- TFL Enrollment not required
- TFL Coverage is automatic if you have Medicare Part A and B
- Coverage starts the first day Medicare Part A and B are in effect
- You must pay Medicare Part B premiums
- Coverage is available worldwide
Learn More about TRICARE and Medicare Eligibility Requirements.
TRICARE and Medicare Turning Age 65 Brochure
This brochure provides information on how to remain TRICARE-eligible after becoming entitled to Medicare at age 65. Click here
How does TRICARE For Life Work?
There isn’t an enrollment card for TRICARE For Life. All you need is your Medicare card and military ID as proof of coverage.
You may visit any authorized provider. >>Find a Doctor
- In most cases, your provider files your claims with Medicare.
- Medicare pays its portion first and sends the claim to the TRICARE For Life claims processor.
- If you want to know what Medicare pays for services covered by Medicare and TRICARE, check out the TRICARE For Life Cost Matrix.
- TRICARE For Life then pays the provider directly for TRICARE-covered services.
- Generally, you'll have no out-of-pocket costs for services that both Medicare and TRICARE cover.
- You’ll have out-of-pocket costs for care that isn’t covered by Medicare and/or TRICARE.
You can get care at military hospitals and clinics, but only if space is available. >>Find a Military Hospital or Clinic
Does TRICARE For Life Work Overseas?
Medicare provides coverage in the U.S. and U.S. Territories. Medicare doesn't provide coverage in any other overseas locations.
When using TRICARE For Life in all overseas locations, whether you live overseas or are traveling overseas, TRICARE is the primary payer and you're responsible for paying TRICARE's annual deductible and cost shares. >>View TRICARE For Life Costs.
If you live overseas, you must have Part B to remain eligible for TRICARE even though Medicare doesn't provide coverage overseas.
Do I have to Pay an Enrollment Fee?
No. You don't pay any enrollment fees, but you must pay Medicare Part A and Medicare Part B monthly premiums. Medicare Part A is paid from payroll taxes while you are working. Your Part B premium is based on your income, but you must have Medicare Part A and Medicare Part B.
For more information about Part B premiums:
- Visit the Medicare website
- Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778)
Will I Have Any Out-of-Pocket Costs?
TYPE OF SERVICE | MEDICARE PAYS | TRICARE PAYS | YOU PAY |
---|---|---|---|
Covered by TRICARE and Medicare | Medicare-authorized amount | Remaining amount | Nothing |
Covered by Medicare only | Medicare-authorized amount | Nothing | Medicare deductible and cost-share |
Covered by TRICARE only | Nothing | TRICARE-allowable amount | TRICARE deductible and cost-share |
Not Covered by TRICARE or Medicare | Nothing | Nothing | Billed charges (which may exceed the Medicare or TRICARE-allowable amount |
To learn more about what TRICARE covers >>Learn more
To learn more about what Medicare covers >>Learn more
Need to file or check the status of a claim? >>Learn more
Using TRICARE For Life with Other Health Insurance
If you have other health insurance, such as a Medicare supplement or an employer-sponsored health plan, you can use TRICARE For Life as long as you have both Medicare Parts A and B. If you have other types of insurance:
TYPE OF INSURANCE | PAYMENT ORDER | FILING A CLAIM |
---|---|---|
Employer-sponsored insurance with current employer. |
|
In this case, your employer with file your health claims. |
Other Health Insurance (OHI) that isn't based on your or a family member's current employment. |
|
In this care, you must file a claim with the TFL contractor. Submit a paper claim to WPS along with a copy of:
|
Your claim must be filed within one year from the date of care. For more information, visit the WPS website.
Can I suspend my FEHB coverage to use TRICARE For Life?
Yes. Call the Office of Personnel Management’s Retirement Information line at 1-888-767-6738 to get a suspension form.
Who Do I Contact If I Need Help?
The TRICARE For Life contractors assist with claims and provide customer service to all those using TRICARE For Life.
- In the U.S. and U.S. Territories: Wisconsin Physicians Service (WPS)
- All other overseas areas: International SOS
Want to Learn More about TRICARE For Life?
Check out the new TRICARE For Life 101 podcast series. The new series helps retired service members or their eligible family members who will turn 65 soon understand their TRICARE For Life benefits. The series covers several topics, from an overview of basics, to how TFL and Medicare interact, and more! >>Learn more
Are you looking to see what tests, items, or services Medicare covers? >>Learn more.
Want to order a hard copy of the TRICARE For Life Handbook? Call Wisconsin Physicians Service (WPS) at 1-866-773-0404.
Last Updated 10/22/2024