TRICARE for Life (TFL) acts as a supplement to Medicare, picking up most costs that Medicare doesn’t cover. When you receive care that both programs cover, Medicare pays first and TRICARE pays the remainder, leaving you with zero out-of-pocket costs in most situations. There are no monthly premiums for TFL itself, but you do need to pay for Medicare Part B, which costs $185 per month in 2025.
Who Qualifies for TRICARE for Life
TFL is available to military retirees, their spouses, and certain survivors who are entitled to Medicare Part A and enrolled in Medicare Part B. You also need to be registered in the Defense Enrollment Eligibility Reporting System (DEERS). Unlike other TRICARE plans, there’s no separate enrollment process for TFL. Once you have both Medicare Part A and Part B and your information is current in DEERS, coverage kicks in automatically.
The critical requirement is Medicare Part B. Many military retirees assume their TRICARE benefit carries them through retirement without changes, but once you become Medicare-eligible (typically at age 65), you lose access to other TRICARE plans and must have Part B to keep any TRICARE coverage. Skipping or delaying Part B enrollment doesn’t just affect your Medicare benefits. It disqualifies you from TFL entirely until you sign up.
How Claims Get Paid
The payment sequence is straightforward: your provider files a claim with Medicare first. Medicare pays its share, then automatically forwards the claim to the TFL claims processor. TRICARE reviews what’s left and pays the provider directly for any TRICARE-covered balance. You don’t need to file separate claims or coordinate between the two programs yourself.
What you owe depends on how the service is categorized:
- Covered by both Medicare and TRICARE: Medicare pays its authorized amount, TRICARE covers the rest. You pay nothing.
- Covered by Medicare only: Medicare pays its share. TRICARE pays nothing. You’re responsible for the Medicare deductible and cost-sharing.
- Covered by TRICARE only: Medicare pays nothing. TRICARE covers the allowable amount, and you pay the TRICARE deductible and cost-share.
- Not covered by either program: You pay the full billed charges, which can exceed what either program would normally allow.
The first category is where most routine medical care falls, which is why many TFL beneficiaries report paying little to nothing for doctor visits, hospital stays, and lab work. The combination effectively eliminates the gaps that Medicare alone would leave.
What It Costs You
TFL has no enrollment fee and no monthly premium. Your only guaranteed recurring cost is the Medicare Part B premium, which is $185 per month in 2025 (with the annual deductible set at $257). Higher-income beneficiaries pay more for Part B based on tax returns from two years prior.
For services covered by both programs, your cost-sharing is typically zero. The real expenses show up when you use services that only one program covers, or that neither covers. Certain alternative therapies, cosmetic procedures, and long-term custodial care fall outside both programs, for example, and would come entirely out of pocket.
The Part B Late Enrollment Penalty
If you don’t sign up for Medicare Part B when you’re first eligible and don’t qualify for a special enrollment period, you’ll face a permanent penalty. The surcharge is 10% added to your Part B premium for every full year you could have enrolled but didn’t. Someone who waited two years would pay a 20% penalty on top of the standard premium for the rest of their time on Medicare.
Beyond the financial penalty, the bigger issue is that delaying Part B means you have no TFL coverage during that gap. You wouldn’t have Medicare supplemental coverage or standard TRICARE. That period of being uninsured or underinsured can be expensive if a serious health issue arises.
Prescription Drug Coverage
TFL beneficiaries keep access to the TRICARE Pharmacy Program, which covers prescriptions through military pharmacies, retail pharmacies, and the mail-order TRICARE Pharmacy Home Delivery program. Military pharmacies remain the cheapest option, with most generic and brand-name drugs available at no cost.
You do not need Medicare Part D to maintain your TRICARE pharmacy benefits. For most TFL beneficiaries, there’s almost no advantage to enrolling in a Part D plan. TRICARE’s pharmacy benefit counts as “creditable coverage,” meaning it’s considered at least as good as Part D. This designation protects you from the Part D late enrollment penalty if you ever decide to sign up later.
The one exception worth considering: if your income is limited, you may qualify for Medicare’s Extra Help program, which subsidizes Part D costs. In that case, comparing a Part D plan’s premiums, copayments, and drug formulary against your TRICARE pharmacy benefit could reveal savings. If you do enroll in Part D, TRICARE becomes the secondary payer for prescriptions, paying after Medicare’s drug plan.
Skilled Nursing Facility Coverage
Medicare covers skilled nursing facility care for up to 100 days following a qualifying hospital stay, but cost-sharing increases significantly after day 20. TFL fills in those costs for the first 100 days. Starting on day 101, TRICARE can continue covering skilled nursing care with no set day limit, as long as the care is medically necessary. You will need a pre-authorization from TRICARE beginning on day 101.
This is one of the areas where TFL provides meaningfully better coverage than Medicare alone or even many Medicare Supplement (Medigap) plans, which typically stop covering skilled nursing after 100 days.
How TFL Works Overseas
Medicare only provides coverage within the United States and U.S. territories. It does not pay for care received in other countries. When you use TFL outside the U.S. and its territories, TRICARE becomes your primary payer. You’re responsible for paying TRICARE’s annual deductible and applicable cost-shares, which are higher than the zero out-of-pocket you’d typically see stateside for dual-covered services.
One important rule catches some retirees off guard: even though Medicare doesn’t cover care overseas, you must keep your Part B enrollment active to remain eligible for TRICARE. Dropping Part B while living abroad would disqualify you from TFL, leaving you without either program’s coverage.
Dental and Vision Coverage
Neither Medicare nor TFL covers routine dental or vision care. Military retirees with TFL can enroll in the Federal Employees Dental and Vision Insurance Program (FEDVIP) to fill this gap. Most retirees qualify for FEDVIP dental coverage, and those enrolled in a TRICARE health plan are also eligible for vision coverage. FEDVIP premiums are paid with post-tax dollars, and dependent children can be covered until age 21 (or 23 if they’re full-time students).
FEDVIP enrollment happens during the annual Federal Benefits Open Season, typically in November and December. Outside of that window, you can only enroll or make changes during qualifying life events like marriage, retirement, or the birth of a child.