Part eleven of Healthcare in Retirement, and I want to open this one differently. If you served, thank you. Twenty years or more in uniform, moves you did not choose, a family that moved with you. In return, this country gives you some of the best health coverage it has to offer, and it asks for almost no paperwork to keep it. That is right, and I am glad it works that way. This article is about making sure it keeps working, because it rests on one thing, and that one thing has a bill.
The situation
You retired from the service. You turned 65. Everyone else in the neighborhood is drowning in plan brochures and you are wondering whether any of it applies to you. One of our callers, a military spouse, said it for a lot of families: "We're learning all this Medicare, Tricare, oh my gosh, and reading EOBs." Another caller, on the other side of a divorce, had a harder version: "I'm on Tricare for life currently, but I won't qualify for it after the divorce, so I will need a supplement program." Both of them were right to call, and for different reasons.
What it is
The Department of Defense describes it in one sentence: "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." Medicare's own page describes the coverage as extending "to Medicare-eligible uniformed services retirees 65 or older, to their eligible family members and survivors, and to certain former spouses." Certain. Not all. The caller above had already learned that.
There is nothing to sign up for. "You don't need to enroll; coverage is automatic once you have Medicare Part A and Part B." It starts the first day both parts are in effect. The only administrative requirement is the one you already met: "You must be registered in the Defense Enrollment Eligibility Reporting System to get your TRICARE benefit." Keep DEERS current. That is the entire enrollment.
The one bill
Here is the sentence that matters most, from the program's own page: "You don't pay any enrollment fees for TFL, but you must pay Medicare Part A and Medicare Part B monthly premiums." The coverage itself has no premium. Part B does, and Part B is not optional. The Department of Defense could not be clearer: "You'll lose your TRICARE coverage if you don't have Part B, if you drop Part B, or you fail to pay your Part B premiums." Three ways to lose it, and all three are the same thing.
I am not an advisor, so let me just do the multiplication. The standard Part B premium in 2026 is $202.90 a month, which is $2,434.80 a year for one person and $4,869.60 for a retired couple who both carry it. If your income is higher, Medicare adds an Income-Related Monthly Adjustment Amount, called IRMAA, based on a tax return from two years ago. At the top bracket the 2026 Part B premium is $689.90 a month. We walked through those brackets in part two. So "little or no cost" is true of the coverage and not true of the ticket to it. Say both halves.
How a claim actually pays
In the United States, "Medicare pays first for Medicare-covered services, and TRICARE may pay second." Medicare processes the claim and passes it along automatically. There are four possible outcomes, and the program's cost page lays them out for 2026:
- Both cover it. Medicare pays its share, TRICARE pays what is left. You pay nothing, as long as the provider accepts Medicare assignment. This is most of your care: the doctor, the hospital, the labs.
- Medicare covers it, TRICARE does not. You pay the Medicare share. The program's own example is chiropractic: Medicare pays 80 percent, TRICARE pays nothing, and you pay the 20 percent Medicare cost-share.
- TRICARE covers it, Medicare does not. "You must pay the TRICARE deductible when TRICARE is the only payer." That deductible is $150 per person or $300 per family in 2026, then a cost-share, with a $3,000 per family yearly cap.
- Neither covers it. You pay the billed charges, and the program warns "There may be no limit to the amount that nonparticipating non-network providers can bill."
Four quadrants. Most of life lives in the first one, which is why the coverage feels like it costs nothing. The other three are where the surprises come from.
What you do not need: a drug plan
This is the question our callers ask most, and the government's answer is a flat no. "TRICARE For Life includes prescription drug coverage through the TRICARE Pharmacy Program. This means you don't need Medicare Part D to have prescription coverage." And because the coverage is creditable, the penalty we spent all of part four on does not apply: "TRICARE is creditable prescription drug coverage. This means you won't pay extra if you decide to enroll in a Medicare prescription drug plan after your Initial Enrollment Period."
What you pay instead, per the official 2026 costs sheet, which runs through the end of 2027: at a military pharmacy, $0 for generics and $0 for formulary brands, up to a 90-day supply. Through home delivery, $14 generic, $44 formulary brand, $85 non-formulary, also 90 days. At a retail network pharmacy, $16, $48, and $85 for a 30-day supply. Compare that to yesterday's article on preferred pharmacy copays and you will see why the program's pharmacy benefit is the quiet star of the whole package. If you buy a Part D plan anyway, Medicare says "your Medicare drug plan pays first, and TRICARE pays second," which for most people is a second premium for coverage they already have. There are narrow exceptions, so ask before you buy one.
Where the paperwork comes back
If you join a Medicare Advantage plan. You can. You keep TRICARE For Life, and "Medicare is still your primary coverage, and TRICARE For Life is the second payer for TRICARE-covered services." Here is the cost that is easy to miss: "Medicare Advantage claims don't crossover to Medicare. This means you will have to file claims for reimbursement of TRICARE-covered services." An automatic benefit becomes a stack of forms. The Advantage marketing season starts in a few weeks. Know this before the calls start, and ask what the plan gives you that you do not already have.
If you travel or live overseas. The order flips. "Medicare provides coverage in the U.S. and U.S. territories. Medicare doesn't provide coverage in any other overseas locations." Outside them, TRICARE pays first and "you're responsible for paying TRICARE's annual deductible and cost-shares," which for retirees overseas is a 25 percent share. And you still pay Part B every month for coverage that does almost nothing there, because "If you live overseas, you must have Part B to remain eligible for TRICARE even though Medicare doesn't provide coverage overseas."
If you never signed up for Part B
I will say this plainly because the program does: there is no TRICARE-specific rescue for a retiree over 65 who skipped Part B. If you worked past 65 with coverage from that job, the ordinary 8-month Special Enrollment Period from Wednesday's article applies to you like anyone else. If not, the program's own page says: "If you didn't sign up for Medicare Part B when you first became eligible, or you dropped it, you can sign up during Medicare's general enrollment period (Jan. 1–March 31 each year)," and "You may have to pay a Medicare Part B late enrollment penalty." That is the General Enrollment Period from Wednesday's article, and the penalty is permanent. Two other narrow exceptions exist: one for people under 65 on Medicare through disability who skipped Part B because they had TRICARE, and one for family members of a sponsor still on active duty, which runs through active duty and "within the first eight months of their retirement." Neither is a door for a 70-year-old retiree who let it lapse.
And the caller going through a divorce: not every former spouse keeps the benefit. Losing it is not one of Medicare's guaranteed-issue situations, so a Supplement may mean answering health questions, and part five explains what that door looks like. Find that out before the divorce is final, not after.
What a Certified Medicare Planner® does differently
They start by saying thank you and then they say the second half of the sentence: the coverage is nearly no cost, and Part B is the bill, and here is what that bill will be for your income. They put Part B on autopay the same day, because a missed premium is the same as dropping it. They tell you, in writing, that you do not need a drug plan and why. When an Advantage brochure arrives they explain the crossover problem before you sign anything. They check DEERS. They know which former spouses keep the benefit and which do not, and when they do not, they know exactly how many days the Supplement window stays open. The advisors are at 602-281-3898.
Friday, October 2. Foothills Library, Glendale, 10:30 AM. Mustang Library, Scottsdale, 2:30 PM. No cost. Register at 123easymedicare.com/medicare-workshop or call (877) 220-1089.
Healthcare in Retirement continues Monday: two addresses, one plan, and the county line. What six months away does to a Medicare Advantage plan, the difference between visiting and moving, and why Original Medicare has no county line.
This event is presented by 123EasyMedicare, a brand of American Retirement Advisors, an independent, private organization. It is not sponsored by, endorsed by, or affiliated with Medicare, the Centers for Medicare & Medicaid Services, the Social Security Administration, or any government agency. The libraries are not sponsors of, and are not affiliated with, this event. Educational only; not tax, legal, or insurance advice.
You Finished the Series
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Disclaimer: This article is for educational purposes only. It is not sponsored, endorsed, or otherwise representative of Medicare or the federal Medicare program. American Retirement Advisors is not a government agency. For official Medicare information, visit medicare.gov or call 1-800-MEDICARE (1-800-633-4227).