TRICARE For Life and Medicare: How They Work Together in 2026

For military retirees and their spouses, turning 65 brings a big change in health coverage. TRICARE Prime or TRICARE Select gives way to TRICARE For Life (TFL). TRICARE describes TFL as "Medicare-wraparound coverage if you're TRICARE-eligible and have Medicare Part A and Part B, regardless of age or place of residence." The catch is simple but serious: no Medicare Part B, no TFL. This guide explains how TFL and Medicare work together, what you pay in 2026, and the mistakes families most want to avoid.

Key Takeaways

• To have TRICARE For Life, you must have both Medicare Part A and Part B.
• There is no TFL enrollment fee, but you pay the Medicare Part B premium, which is $202.90 a month for most people in 2026.
• Medicare pays first and TFL pays second. TRICARE says that, generally, you have no out-of-pocket costs for services both programs cover.
• TRICARE advises enrolling in Medicare at least two months before you turn 65 to avoid a gap in TRICARE coverage.
• Medicare Parts C and D are optional for TFL. You keep the TRICARE Pharmacy Program either way.
• Outside the U.S. and its territories, Medicare does not pay, so TRICARE becomes the primary payer and you pay TRICARE's deductible and cost-shares.

Table of Contents

• What TRICARE For Life Is
• How TFL and Medicare Pay Your Bills
• What You Pay in 2026
• Prescriptions, VA Care, and Living Overseas
• Steps to Get TFL Coverage Right
• Ask the Navigator
• Frequently Asked Questions
• Sources

From the AVOY Book Library VA Health Care Benefits for Veterans and Families covers this in more depth, with step-by-step guidance. Get the Book →

What TRICARE For Life Is

TFL is not a separate health plan you sign up for. It is TRICARE coverage that works alongside Medicare.

Who qualifies

TFL is for people who are TRICARE-eligible and have Medicare Part A and Part B. It applies "regardless of age or place of residence." That means someone under 65 who has Medicare because of a disability can also use TFL, as TRICARE explains on its Medicare page.

It is automatic

TRICARE says, "You aren't required to enroll in TFL... TFL coverage is automatic if you have Medicare Part A and Part B." There are no TFL enrollment fees. TRICARE's newsroom adds that coverage begins "the first day that you have both Medicare Parts A and B."

It is individual

TRICARE calls TFL "an individual entitlement." If one spouse turns 65 and the other is younger, the younger spouse who is not eligible for Medicare can keep TRICARE Prime or TRICARE Select coverage. Family members under 65 have 90 days from the Medicare-eligible family member's Medicare effective date to request a plan change.

How TFL and Medicare Pay Your Bills

Think of Medicare as the first payer and TFL as the second. TRICARE explains the order: Medicare processes the claim first and pays its share. The claim then goes to the TFL claims processor, and TRICARE pays the provider for any remaining TRICARE-covered amount.

Three kinds of services

TRICARE's 2026 TFL cost matrix sorts care into three groups:

• Covered by both Medicare and TRICARE: Medicare pays the Medicare-approved amount, and TRICARE pays the rest. You generally pay nothing.
• Covered by Medicare only: You pay the Medicare deductible and cost-share. TRICARE pays nothing.
• Covered by TRICARE only: You pay the TRICARE deductible and cost-share.

Military hospitals and clinics

Medicare.gov notes, "If you get items or services from a military hospital or clinic, or any other federal health care provider, TRICARE pays. Medicare usually doesn't pay for services you get from a federal health care provider."

What You Pay in 2026

TFL has no enrollment fee, but it is not free. Your main cost is the Medicare Part B premium.

Medicare amounts for 2026

• Part B premium: $202.90 a month (standard), per CMS. Higher-income people pay more.
• Part B deductible: $283 a year.
• Part A deductible: $1,736 per inpatient hospital benefit period.
• Part A premium: CMS says about 99% of beneficiaries do not pay one.

TRICARE amounts for 2026

• TRICARE deductible (for TRICARE-only services): $150 per person or $300 per family each year.
• Catastrophic cap: $3,000 per family each year for TRICARE-covered out-of-pocket costs.

Do not skip Part B

TRICARE is clear: "You need to have Medicare Part A and Part B to have TFL." If you do not have Part B, TRICARE says your coverage is limited and "you can only get your prescriptions filled at military pharmacies." Medicare also has a Part B late enrollment penalty. Medicare.gov says you pay "an extra 10% for each year you could have signed up for Part B, but didn't," for as long as you have Part B. Medicare.gov does list TRICARE status among the situations that can qualify for a Special Enrollment Period, so anyone in that spot can ask Social Security about it.

Prescriptions, VA Care, and Living Overseas

Prescriptions

TRICARE says, "You don't need Medicare Part D. TFL beneficiaries remain eligible for the TRICARE Pharmacy Program." If you do choose Part D, it pays first for prescriptions and TRICARE pays second. TRICARE's 2026 pharmacy copays for retirees and their families are:

• Military pharmacy (up to a 90-day supply): $0 for generic and brand-name formulary drugs.
• Home delivery (up to a 90-day supply): $14 generic, $44 brand-name, $85 non-formulary.
• Retail network pharmacy (up to a 30-day supply): $16 generic, $48 brand-name, $85 non-formulary.

Medicare Advantage

TRICARE says Part C (Medicare Advantage) is optional. If you join one, you must use its network providers and file claims with TFL for copay reimbursement.

Using VA care with TFL

Many military retirees are also VA-enrolled veterans. TRICARE recommends getting care for service-connected disabilities at a VA facility. For care not related to service, the math changes. TRICARE says "Medicare can't pay for care at a government facility," and at VA facilities "TRICARE can pay only up to 20% of the TRICARE-allowable charge." TRICARE notes that when using Medicare providers, "you typically have no out-of-pocket costs for services covered by both Medicare and TRICARE." For more on family coverage, see our guide on CHAMPVA vs. TRICARE.

Living overseas

TRICARE says, "Medicare provides coverage in the U.S. and U.S. territories. Medicare doesn't provide coverage in any other overseas locations." Overseas, TRICARE becomes the primary payer, and you owe TRICARE's deductible and cost-shares. The 2026 cost matrix lists a 25% cost-share for TRICARE-covered services overseas, and TRICARE says you also pay its annual deductible. You still need Part B to keep TFL, even if you live abroad.

Steps to Get TFL Coverage Right

Here is a simple order many families follow. It is educational only.

1. Check DEERS. TRICARE says to check DEERS regularly so your eligibility information stays current.
2. Plan ahead of your 65th birthday. TRICARE advises enrolling in Medicare at least two months before you turn 65.
3. Sign up for Part A and Part B. Both are required for TFL.
4. Budget for the Part B premium. It is $202.90 a month for most people in 2026.
5. Decide on Parts C and D. Both are optional with TFL.
6. Set up your pharmacy plan. Compare military pharmacy, home delivery, and retail copays.
7. Review younger family members' coverage. Spouses under 65 may need a plan change within 90 days.

Ask the Navigator

Have questions about TRICARE For Life, Medicare, or using VA care at the same time? Ask AVOY Veteran Navigator AI™ at avoyvet.com. Then take the free Veteran Legacy Checklist to make sure your health coverage and family plans are in order.

Frequently Asked Questions

Do I have to enroll in TRICARE For Life?

No. TRICARE says TFL coverage is automatic if you are TRICARE-eligible and have Medicare Part A and Part B.

Does TRICARE For Life cost anything?

There is no TFL enrollment fee. You pay the Medicare Part B premium, which is $202.90 a month for most people in 2026.

Do I need Medicare Part D with TFL?

No. TRICARE says Part D is optional and TFL beneficiaries remain eligible for the TRICARE Pharmacy Program.

Does TFL work if I live outside the United States?

Yes, if you keep Medicare Part A and Part B. Medicare does not pay outside the U.S. and its territories, so TRICARE pays first overseas and you pay TRICARE's deductible and cost-shares.

Can I use TFL at a VA hospital?

For non-service-connected care at a VA facility, TRICARE can pay only up to 20% of the TRICARE-allowable charge, and Medicare cannot pay. TRICARE recommends using VA for service-connected care.

Sources

• TRICARE For Life — TRICARE.mil
• TRICARE For Life Cost Matrix 2026 — TRICARE.mil
• Becoming Medicare-Eligible — TRICARE.mil
• Q&A: How Does TRICARE For Life Work With Medicare? — TRICARE Newsroom
• Do You Need All 4 Parts of Medicare for TRICARE For Life? — TRICARE Newsroom
• Using TRICARE For Life at Veterans Affairs Facilities — TRICARE.mil
• Pharmacy Costs — TRICARE.mil
• 2026 Medicare Parts A & B Premiums and Deductibles — CMS.gov
• Avoid late enrollment penalties — Medicare.gov
• When does Medicare coverage start? — Medicare.gov
• Who pays first? — Medicare.gov

Educational information only — not legal, tax, financial, or medical advice, and not affiliated with the U.S. Department of Veterans Affairs. Estate and probate rules vary by state; an estate attorney in your state can confirm what applies. For VA benefits help, contact a VA-accredited VSO (often free), claims agent, or attorney.