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Medicare Part B is medical insurance. If you need dental and vision cov-
Coverage includes outpatient care, TRICARE erage, you may qualify to purchase
®
home health care, durable medical AND MEDICARE this coverage through the Federal
equipment, and some preventive ser- TURNING AGE 65 Employees Dental and Vision
vices. Medicare Part B has a monthly Insurance Program.
premium based on your income.
TRICARE For Life is Medicare-wraparound coverage for retirees and their family members who are
You don’t need to enroll in Medicare
eligible for Medicare Part A and Part B. Learn how Medicare affects your TRICARE coverage at age 65.
You don’t need Medicare Part C or REMAINING TRICARE-ELIGIBLE Part D to have drug coverage. With
Part D to have TFL. If you’re entitled to premium-free Medicare Part TURNING AGE 65 CHECKLIST TFL beneficiaries remain eligible for
A, you must also have Medicare Part B to keep
TRICARE, regardless of your age or place of Sign up for Medicare Part A
residence (exceptions to this rule are discussed Sign up for Medicare Part B the TRICARE Pharmacy Program.
in the Delaying Medicare Part B Enrollment Review your information in DEERS to
section). Once you have both Medicare Part A make sure it’s current
Medicare Part C refers to Medicare and Part B, you automatically receive TRICARE
benefts under TRICARE For Life (TFL). TFL
is the health plan for TRICARE benefciaries TFL is an individual entitlement. Coverage is
Advantage plans. Private companies who have Medicare Part A and Part B. Medicare only for the Medicare- and TRICARE-eligible If you enroll in Medicare Part D,
Part C (Medicare Advantage plans) and Part D
benefciary. Tis means your new TFL coverage
(prescription drug coverage) aren’t required for at age 65 doesn’t extend to family members.
contract with Medicare to offer these you to have TFL coverage. Your spouse younger than age 65 would remain you’ll pay a monthly premium. You’ll
eligible for TRICARE Prime or TRICARE Select
Keeping your information up to date in the
Defense Enrollment Eligibility Reporting System until they turn age 65 and become eligible for
plans. Coverage includes Medicare (DEERS) is key to ensuring efective, timely Medicare Part A and Part B. also need to follow your Medicare
delivery of your TRICARE benefts.
Part A and Part B. Some plans also Part D plan’s rules for where to get
include vision, dental, and prescrip- This brochure is not all-inclusive. For additional information, please visit www.tricare.mil/tf prescriptions. Learn more about using
or contact the TRICARE For Life contractor.
tion drug coverage. https://tricare.mil/Publications/Brochures/ Medicare Part D with TRICARE.
medicare_turning_65
Medicare Part D is prescription drug Q: Does Medicare or TRICARE
coverage. Private companies contract pay first?
with Medicare to offer these plans. A: If both Medicare and TRICARE
TRICARE cover the service, TRICARE pays
®
Q: What should I know AND MEDICARE last. However, Medicare doesn’t cover
about the optional parts of UNDER AGE 65 all services that TRICARE covers. Be
Medicare (Part C and Part D)?
sure to check whether your health
Remaining TRICARE-eligible when you become entitled to Medicare before age 65
A: With Medicare Part C, you may You may become entitled to Medicare under age 65 in Depending on your eligibility status, you may be eligible for: care services are covered by Medicare,
certain circumstances:
pay a monthly premium in addition • End-Stage Renal Disease (ESRD): You may become • TRICARE Prime®: If you’re entitled to Medicare Part TRICARE, or both, so you aren’t sur-
A, you may remain enrolled in TRICARE Prime until
eligible for Medicare coverage beginning on:
reaching age 65, as long as you continue to meet all
■ The first day of the fourth month of renal dialysis eligibility requirements. Additionally, if you’re age 65 or
to your Medicare Part B premium. If ■ The first month of a regular course of dialysis older, you may remain in TRICARE Prime if you have prised by any out-of-pocket costs.
treatment
an active duty sponsor. Active duty service members
treatments, if you meet both of these conditions: (1) (ADSMs) must be enrolled in TRICARE Prime regardless
of Medicare entitlement status. ADSMs and their family
You participate in a home, dialysis training program
you choose to enroll in Part C: offered by a Medicare-approved training facility during members entitled to Medicare Part A can avoid paying
the Medicare Part B late-enrollment monthly premium
the first three months of your regular course of dialysis;
and (2) Your doctor expects you to finish training and surcharge by enrolling during their Part B Special
Enrollment Period (SEP). This doesn’t apply to those with
be able to do your own dialysis treatments.
n You must get all none- ■ The month you’re admitted to a Medicare-certified ESRD. The SEP is available anytime while the sponsor is Q: What if I have other
on active duty and you’re covered by TRICARE, or within
hospital for kidney transplant, if your transplant the first eight months following either: (1) the month
takes place in that same month or within the next
mergency health services two months; or two months before your transplant, if your sponsor’s active duty status ends or (2) the month health insurance?
TRICARE coverage ends, whichever comes first. To avoid
your transplant is delayed more than two months after
a break in TRICARE coverage, ADSMs and active duty
admission to the hospital. family members must sign up for Medicare Part B before
from that plan’s network of • Disability: You become eligible for Medicare beginning retired service members and their family members who A: TFL pays after Medicare and
the sponsor’s active duty status ends. Regardless of age,
the 25th month of receiving Social Security Disability
are entitled to premium-free Medicare Part A must have
Insurance (SSDI) payments. The Social Security
Part B to remain TRICARE-eligible.
Administration (SSA) notifies you of your Medicare
providers. Learn more about Medicare eligibility at www.medicare.gov. • TRICARE For Life (TFL): The TFL program provides
entitlement start date.
Medicare-wraparound coverage for TRICARE
n You may pay copayments at If you’re entitled to premium-free Medicare Part A before beneficiaries who have both Medicare Part A and Part B, other health insurance (OHI),
regardless of age or place of residence. When using
Medicare providers, TFL beneficiaries typically have no
age 65, you may need to have Part B coverage in order to keep
your TRICARE benefit. The charts that follow take into
account the reason for your Medicare eligibility and your out-of-pocket costs for services covered by both Medicare such as insurance based on your or
the time of service. sponsor’s status and will help you determine if you must have
Medicare Part B to keep TRICARE.
n You may need to file paper your spouse’s current employment.
Find more information about how
claims for TRICARE https://www.tricare.mil/Publications/ Medicare and TFL interact with OHI
Brochures/medicare_under_65
to reimburse you for in the TRICARE for Life Handbook.
TRICARE-covered services
you receive.
Be sure to explore all your options and enroll in Medicare at least two
months before you turn 65 to avoid any gaps in TRICARE coverage. Keep
your contact information up to date in the Defense Enrollment Eligibility
Reporting System to ensure timely delivery of your TRICARE benefits.
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