TRICARE vs. Medicare
TRICARE is a government-sponsored health insurance program for uniformed service members and their families, as well as members and family members of the National Guard and Reserves. Medicare is a government health insurance program for seniors and younger people with certain illnesses and disabilities.
If you’re enrolled in a TRICARE plan and wondering if you should switch to Medicare, you may be surprised at your options.
What does TRICARE cover?
TRICARE may cover physical health care, mental health care, dental care, and vision care. In addition, TRICARE offers a prescription drug benefit. TRICARE benefits depend on your duty status, where you live, and the plan you choose.
If you are retired or active-duty and eligible for Medicare, you may still be eligible for coverage through a TRICARE plan.
Do I need to switch to Medicare from TRICARE when I turn 65?
In most cases, if you are eligible for premium-free Medicare Part A, you must enroll in Medicare Part B to keep your TRICARE benefits. Once you are enrolled in both Part A and Part B, you are automatically covered by TRICARE for Life if you qualify. There is no additional monthly premium for TRICARE.
If you are still on active duty when you become eligible for Medicare, you can delay your Part B enrollment and still keep your TRICARE Prime or TRICARE Select plan. However, when active duty ends, you need to enroll in Medicare Part B to maintain your TRICARE eligibility.
What does TRICARE for Life cover?
TRICARE for Life is coverage that works with your Medicare coverage. Under TRICARE for Life, Medicare is the primary payer and TRICARE pays after Medicare for covered services. Payment is made directly to your provider to keep your out-of-pocket costs low.
If you are overseas and need health care, TRICARE is your primary insurer, since Medicare does not cover services in a foreign country except in very limited circumstances.
Do I get vision and dental benefits under Medicare or TRICARE for Life?
There are no benefits for routine vision and dental care under Medicare. However, if you are covered by TRICARE for Life, you may be able to enroll in the Federal Employees Dental and Vision Insurance Program (FEDVIP). This is a voluntary program and there is an additional monthly premium for FEDVIP if you are eligible.
If you choose to get your Medicare benefits through a Medicare Advantage plan, your plan may include coverage for routine vision and dental services. Not all plans include these extra benefits, however, so you should compare plans available in your area to see which one has the type of additional coverage you want.
Do I need a Medicare Part D Prescription Drug Plan if I have TRICARE for Life?
Most people see no financial benefit in adding Medicare Part D prescription drug coverage to their TRICARE benefits, since TRICARE for Life includes creditable prescription drug coverage under Medicare rules. You don’t need to enroll in a Medicare prescription drug plan to remain eligible for TRICARE for Life.
If you choose to enroll in a Medicare Advantage plan with Part D coverage included, you do not lose your pharmacy benefits under TRICARE for Life. Your TRICARE plan will pay after your Medicare prescription drug plan for covered prescription medications.
Should I buy a Medicare Supplement plan if I have TRICARE?
Medicare Supplement insurance plans generally cover some or all of your out-of-pocket costs with Part A and Part B. You pay a separate monthly premium for Medicare Supplement plans.
Since TRICARE for Life pays after Medicare pays, people covered by both plans tend to have very few out-of-pocket costs. TRICARE for Life is premium-free to qualifying enrollees.
Therefore, generally TRICARE for Life members do not need to buy a Medicare Supplement plan.