TRICARE For Life and Medicare Advantage: What Military Retirees Should Know Before Switching

Military retirees are not the same as veterans who use the VA, and the advice for them is different. This guide is for retirees who have, or are about to have, TRICARE For Life. If you're a veteran who isn't a military retiree, start with our Medicare Advantage for veterans guide.

How does TRICARE For Life work with Medicare?

TFL is TRICARE's coverage for Medicare-eligible military retirees and their eligible family members. VA's guidance describes it this way: TFL covers deductibles, copays, and costs for non-VA care that Medicare alone doesn't cover, and you must be enrolled in Medicare Parts A and B to keep TRICARE. TRICARE adds that Medicare pays first and TFL pays last, and that with Original Medicare, after Medicare processes your claim it forwards it to TFL, so you don't have to file one.

Because TFL fills most of the gaps in Original Medicare, many retirees find that Original Medicare plus TFL is a complete, low-cost combination, which is a big reason this audience should be careful about switching.

What changes if I join a Medicare Advantage plan?

TFL and Medicare Advantage can work together, but they don't work the same way as TFL with Original Medicare. TRICARE says that if you enroll in a Medicare Advantage plan, TRICARE can reimburse you for copayments you paid for TFL services, and you may need to file your own claim. That's different from the automatic hand-off you get with Original Medicare. You also take on the plan's rules: networks, referrals, and prior authorizations, which TFL doesn't have with Original Medicare.

Because the details can differ by plan and change over time, confirm with TRICARE how they would coordinate with a specific plan before you enroll. TRICARE's Medicare and TRICARE page is the best place to start.

When might a Medicare Advantage plan still make sense for a retiree?

• You'd value extra benefits, like dental, vision, or hearing, that Original Medicare and TFL don't cover.
• A plan with a low premium or a Part B premium reduction would save you real money, and you're comfortable with a network.
• You live in Florida most of the year and the plan's network includes the doctors and hospitals you use.

When is Original Medicare plus TFL usually the better fit?

• You want to see any Medicare doctor or hospital in the U.S. without a network or referrals.
• You travel often and want the same coverage everywhere.
• You'd rather have claims move automatically from Medicare to TFL.

Questions to ask before you switch

1. How will TRICARE coordinate with this specific plan, and will I have to file claims myself?
2. Are my doctors, hospitals, and the military treatment facilities I use affected?
3. What are the plan's copays, and how much of them will TRICARE reimburse?
4. What happens if I want to leave the plan later?
5. If I currently have a Medigap plan, can I get it back?

If you'd like help working through these for your situation, we're glad to. We'll tell you if Original Medicare plus TFL is the better choice, even if that means we don't enroll you in a plan. Our South Florida Medicare broker page explains how we work.

Turning 65 soon with TRICARE?

Don't wait. TFL starts only after both Medicare Parts A and B are active, and TRICARE advises enrolling at least two months before the month you turn 65 to avoid a break. See our veterans turning 65 checklist.