MOAA’s TRICARE Guide: Medicare and TRICARE For Life

November 01, 2025

Editor’s Note: This article by MOAA staff is part of MOAA’s 2025-26 TRICARE Guide, brought to you by MOAA Insurance Plans, administered by Association Member Benefits Advisors (AMBA). A version of the guide appeared in the November 2025 issue of Military Officer magazine.

When you’re 64, it’s a good time to get out the calendar and plan ahead for Medicare. You’ll want to be ready ahead of your 65th birthday since you can enroll in Medicare up to three months before the big day.

You and your spouse each individually “age out” of the TRICARE benefit (Prime or Select) on the last day of the month prior to your 65th birth month. If your 65th birthday is in February, for example, your TRICARE coverage expires Jan. 31, also the day your military ID card expires. An older spouse has already transitioned; a younger spouse remains in the TRICARE plan of choice until turning 65.

[PREMIUM/LIFE MEMBER EXCLUSIVE: Transitioning Into Medicare and TRICARE For Life]

Once you’ve signed up for Medicare, it might take several weeks for your Medicare card to arrive in the mail. It’s smart to plan ahead for the day your coverage stops. Your three health care options are:

Enroll in Medicare.
Use an employer-provided plan. This applies to either working spouse.
For the veteran, use VA health care.

Once you are enrolled in Medicare, your options for Medicare plans are:

Original Medicare (OM) Part A (hospitalization) and Part B (medical insurance).
Medicare Advantage plan Part C, the open-market commercial equivalent to OM parts A and B.

TRICARE For Life (TFL) beneficiaries do not need Medicare Part D (pharmacy), and Advantage plan enrollees using TFL should avoid plans with Part D coverage.

Seven-Month Window

You can sign up for Medicare parts A and B during the seven-month window that starts three months before your birth month and ends three months after your birth month.

Your military ID card expires in the month before your 65th birthday to ensure you enroll in Medicare parts A and B and in TFL. Once you receive your Medicare card, you can renew your military ID card.

Here are recommended steps to get Medicare:

Enroll in Medicare online two to three months before your 65th birth month. However, if you are receiving Social Security retirement benefits at least four months prior to your 65th birth month, you are automatically enrolled in Medicare parts A and B on the first day of your 65th birth month.
After enrolling in Medicare, schedule an appointment to renew your ID card at a nearby military ID card office. Leave at least two to three weeks of leeway to ensure you receive your Medicare insurance card in the mail.
Show the ID clerk your Medicare insurance card and ask for confirmation your TFL is activated.

Still Working?

If you are still employed, this is one case that allows you to delay Medicare enrollment without incurring the Medicare late enrollment premium penalty.

If either the retiree or spouse works past age 65 and can receive coverage from the employer’s health care plan, then either spouse can delay Medicare enrollment until the working spouse’s employment ends or the employer’s health plan stops. At that point, you have eight months to enroll in Medicare. Plan carefully to start Medicare to prevent a gap before your employer plan ends.

While you are working, you have these options:

Continue your employer plan without Medicare and TFL as well as without TRICARE pharmacy.
Drop employer health care and use Medicare and TFL.
Enroll in Medicare and TFL, plus keep your employer plan. At this point, you are overinsured.

First Steps With Medicare

Check whether your current medical providers accept Medicare. If not, find providers who do.

Because OM (parts A and B) works like TRICARE Select or preferred provider organizations, you can choose any providers, including specialists, that accept Medicare.

Plan to pay your monthly premium for Medicare Part B. The amount is determined by your income level as shown in the previous two years’ reported tax filings from the IRS.

How Medicare and TFL Work

Medicare and TFL are linked in-system. Health care providers bill Medicare as the primary payer.

Residual costs automatically go to TFL for final payment as the second payer. No other Medicare supplementary insurance is needed.

Medicare enrollment in parts A and B, or a Medicare Advantage plan Part C, entitle military retirees, spouses, and surviving spouses to TFL, which acts as your Medicare supplement, covering the Medicare annual deductible, which is $257 in 2025, and 20% of copays.

Each year, your program will automatically roll over to the next year. Keep your military ID card and all personal data up to date for the Defense Enrollment Eligibility Reporting System (DEERS) and Defense Finance and Accounting Service or the Coast Guard’s Pay and Personnel Center.

Spouses Turning 65

A spouse who turns 65 first enrolls in Medicare/TFL, and a younger spouse stays in TRICARE Prime or Select until age 65. Your TRICARE contractor should adjust the annual enrollment fee from family to single rate for the younger spouse if that individual is an empty nester.

Changing Plans

You can change your Medicare plan if you want during the appropriate Medicare open season:

Oct. 15 through Dec. 7 is for OM enrollees who want to switch to an Advantage plan or join OM from an Advantage plan. New plans start Jan. 1.
Jan. 1 through March 31 is for Advantage plan members who want to switch Advantage plans or join OM.

The new plan starts the next month after the company processes the request.

If your income drops because of a change such as divorce, retirement, or death, you can appeal your income level and Part B premium amount.

Pharmacy Plans

Pharmacy plans are Part D under Medicare. You do not need another pharmacy plan on top of your TRICARE pharmacy plan.

If you want a Medicare Advantage plan, choose carefully, as many come with a pharmacy plan that must pay first before TFL pays. To receive reimbursement for what the other plan does not pay, you will have to manually file claims to the TRICARE pharmacy. TRICARE pharmacy copays will apply.
By having another pharmacy plan, you lose your TRICARE home delivery option.

Retired Civilian Workers

If you have a retiree health care plan, you do not have to enroll in Medicare/TFL. You will not have TFL nor TRICARE pharmacy. If you ever want to enroll in Medicare later, you will pay a premium penalty for delayed Part B enrollment for the rest of your life.

TFL will start at enrollment in parts A and B. It is a supplement for Medicare parts A and B (or a Medicare Advantage plan Part C), and it doesn’t work with any other plans. Many civilian plans can be suspended rather than canceled.

Overseas Travel

Medicare plans do not cover you when you are overseas. Instead, your TFL plan acts as your primary coverage and operates like TRICARE Select with deductibles and copays — but with a $3,000 catastrophic cap. Here’s how it works: