Medicare is a health insurance program for people:
- Age 65 or older
- Under age 65 with certain disabilities
- With end stage renal disease
- With Lou Gehrig's disease
The Centers for Medicare & Medicaid Services manages Medicare:
- Medicare Part A is hospital insurance. You usually don't pay a monthly premium for Part A if you or your spouse paid Medicare taxes while working.
- Medicare Part B is medical insurance. You pay a premium each month.
- Medicare Part D is pharmacy coverage. You pay a premium each month.
Using Medicare and TRICARE Together
If you have Medicare Part A, you must also have Medicare Part B to remain eligible for TRICARE, including prescription drug coverage.
You don't need to sign up for Part B if you're:
- An active duty service member
- An active duty family member
- Enrolled in TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult, or the The US Family Health Plan.
Prescription Drug Coverage
You must have Medicare Part B, unless you qualify for an exception listed above. You can continue to get prescriptions filled with no break in coverage as long as you have Medicare Part B when you first become eligible for Medicare Part A.
Medicare Part D, a prescription drug plan, is available to everyone with Medicare. You don't need Part D to keep TRICARE. If you meet certain income and resource limits, you may qualify for extra help from Medicare to pay Part D premiums.
TRICARE For Life
When you have Medicare Parts A and B, you can use TRICARE For Life.
- Medicare is your primary payer.
- TRICARE is the second payer, so your out-of-pocket expenses are less.
- TRICARE benefits include covering Medicare's coinsurance and deductible for services covered by Medicare and TRICARE.
- When retired service members and their families become eligible for TRICARE For Life, typically at 65, they are no longer able to enroll in TRICARE Prime.
US Family Health Plan (USFHP)
As of October 1, 2012 once you become eligible for Medicare at age 65, you can no
longer enroll or stay enrolled in the USFHP.
If you enrolled in USFHP before October 1, 2012, you can stay enrolled as long as you stay enrolled and there is no break in coverage.
What about my family members?
If you’re turning 65, but you still have family members under age 65, they can continue to use TRICARE Prime, TRICARE Standard and Extra, or whatever plan they're using now until they also become eligible for Medicare Part A & B.
Click here for a Fact Sheet that describes how the two health insurances work together.