TRICARE For Life (TFL) is Medicare-wraparound coverage
available to:
- Medicare-eligible uniformed service retirees, including
retired guard members and reservists, - Medicare-eligible family members and widows/widowers (dependent
parents and parents-in-law are excluded), - Medicare-eligible Congressional Medal of Honor recipients
and their family members - Certain Medicare-eligible unremarried former spouses.
Is your Information Updated in the Defense Enrollment
Eligibility Reporting System (DEERS)?
To take advantage of TFL, you and your eligible family members’
information must be up-to-date in DEERS. You may update your
information by phone or by visiting your nearest ID card issuing
facility. Visit www.dmdc.osd.mil/rsl
to locate the nearest ID card facility.
Medicare Part B Requirements for TFL
To participate in the TFL program, you must be entitled to
Medicare Part A and enrolled in Medicare Part B. A Medicare-eligible
beneficiary who is a family member of an active duty service
member (ADSM) is NOT required to purchase Part B. However,
when the ADSM retires, the Medicare-eligible beneficiary is
required to purchase Medicare Part B.
Medicare Part B Penalty Waiver and Special Enrollment Period
The Medicare Prescription Drug, Improvement and Modernization
Act of 2003 makes two very important changes relating to enrollment
in Medicare Part B for certain uniformed services beneficiaries.
First, it eliminates the Medicare Part B surcharge for uniformed
services beneficiaries who were subject to a higher premium
(currently paying more than $78.20 a month) for enrolling
in Part B during the years 2001 to 2004.
Second, the legislation provides the opportunity for uniformed
services beneficiaries who are entitled to Medicare Part A
but are not enrolled in Medicare Part B to enroll in Part
B without a premium surcharge. For more information, please
visit the TRICARE For Life
and Medicare Part B page.
Costs
There are no TRICARE enrollment fees or TRICARE annual premiums;
you must (if other than an active duty family member) pay
your monthly Medicare Part B premium. With TFL, if your only
health insurance program is Medicare (Part A and Part B),
TRICARE acts as second payer to Medicare. TRICARE pays your
remaining out-of- pocket expenses (Medicare deductibles and
cost shares) for services paid by Medicare and covered by
TRICARE. If the service received is not a covered service
under TRICARE, you are responsible for paying the Medicare
deductibles, cost-shares, co-payments, and/or other fees associated
with having received that service. Also, if the service is
authorized by TRICARE but not authorized by Medicare, there
maybe an associated TRICARE deductible and cost-share.
TFL Claims
The TRICARE Dual-Eligible Fiscal Intermediary Contract (TDEFIC)
is a single, nationwide contract for claims processing, customer
service and administrative services for individuals who are
dually eligible for TRICARE and Medicare, regardless of whether
they are over or under age 65. TRICARE Management Activity
awarded this contract to Wisconsin Physicians Service (WPS)
of Madison, Wisconsin. You may call WPS TRICARE For Life (TFL)
at 1-866-773-0404
For more information on TFL benefit, the following resources
are available to you:
Fact Sheet: Dual Eligibility and TRICARE For Life
TRICARE
For Life Brochure
TFL Claims
Processors
TFL Cost Matrix
English
Spanish
TRICARE
For Life News Releases
Federal Register Interim Final Rule for TFL
Online
Version (html)
Print
Version (pdf)
Federal Register Interim final rule for FEHBP
Online
Version (html)
