Military retirees and their spouses will no longer be eligible for regular TRICARE coverage after the age of 65. At this point, health care coverage will be provided primarily through TRICARE for Life, or “TFL”, in conjunction with Medicare and, if applicable, the VA. TRICARE for Life expands on the coverage available for Medicare Part A eligible retirees who have also purchased Medicare Part B. Any sponsor or spouse enrolled in TRICARE before the age of 65 will automatically be enrolled in TRICARE for Life upon reaching the age of 65.
TRICARE for Life is available to:
- Uniformed Services retirees, including National Guard or Reserve members who receive retired pay
- Medicare-eligible family members
- Medicare-eligible widows and widowers
- Certain former spouses
- Anyone entitled to Medicare Part A due to chronic renal disease or disability
Dependent parents and in-laws are not eligible for TRICARE for Life, although they may still be eligible for treatment at military treatment facilities on a space-available basis.
Sometime after passing the 90-day mark before a service member or spouse’s 65th birthday, DEERS will automatically notify beneficiaries of impending changes to their coverage. At this time, beneficiaries will be required to enroll in Medicare Part B to be eligible for the transition to TRICARE for Life. Once enrolled, TRICARE for Life will cover health care costs above that paid by Medicare, starting on the first day of the month of the beneficiary’s 65th birthday.
When receiving medical treatment, TRICARE for Life members only need to show a military ID card in addition to providing their Medicare information; there is no special TRICARE for Life ID card over and above a Medicare card and a military ID. The provider will bill Medicare, who will in turn bill TRICARE for Life. There is no copay associated with these visits, and there is no authorization required to see a provider that is not a part of the TRICARE network, as TRICARE will use the providers Medicare account information to process the claim. (Admission into a hospital for mental health reasons is a notable exception to the no-authorization-required policy.)
TRICARE recognizes all providers who accept Medicare as TRICARE-authorized service providers by default, however, these providers may not accept TRICARE’s maximum allowable payment as payment-i-full for treatment.
Since overseas providers do not accept Medicare, TRICARE for Life will be the primary payer for all claims submitted. For retirees living overseas, TRICARE for Life coverage is nearly identical to TRICARE Standard coverage available to retirees under the age of 65.
TRICARE for Life retirees and eligible beneficiaries may seek treatment at a VA facility for conditions unrelated to service, however the cost-share associated with these visits is a substantial 80 percent of the TRICARE maximum. For this reason, it is highly recommended that TRICARE for Life beneficiaries seek treatment through Medicare for conditions unrelated to service. Only high-priority veterans with significant disability ratings due to service-related conditions will be exempt from this cost-share requirement.