SEPTEMBER 15, 2023 – For many families, staying healthy is a big priority. If you’ll be eligible for TRICARE For Life (TFL) soon, you might be wondering how this affects your family’s health care coverage.
“Your TFL eligibility is based in part on your eligibility for Medicare,” said Anne Breslin, TRICARE For Life program manager at the Defense Health Agency. “When you become eligible for Medicare, your family members who aren’t yet eligible for Medicare may stay in their current TRICARE plans.”
Keep reading to learn how your family’s TRICARE coverage works when one family member becomes eligible for Medicare.
Q: Who’s eligible for TFL?
A: TFL is for military retirees and their eligible family members who are entitled to TRICARE and have Medicare Part A and Medicare Part B, regardless of age, as outlined in the TRICARE For Life Handbook. TFL coverage is automatic once:
- You have both Medicare Part A and Part B
- You show as TRICARE-eligible in the Defense Enrollment Eligibility Reporting System
Q: I’ve heard that TFL is an individual entitlement. What does this mean, and how does it affect my family?
A: This means that TFL only covers the person who has Medicare Part A and Part B. Your family members who aren’t eligible for Medicare may stay in their current TRICARE health plan as long as they’re eligible.
Q: Is becoming eligible for Medicare a TRICARE Qualifying Life Event?
A: If you become eligible for Medicare at age 65, you won’t have a Qualifying Life Event, but your TRICARE-eligible family members under age 65 will. These family members can make eligible changes to their TRICARE health plan within 90 days of the Medicare-eligible family member’s Medicare effective date.
Learn more at Becoming Medicare-Eligible.
Q: I didn’t sign up for Medicare Part B during my Initial Enrollment Period. How does this affect my family members’ TRICARE coverage?
A: It doesn’t. Family members who aren’t eligible for Medicare may stay in their current health plan as long as they’re TRICARE-eligible.
Remember, if you’re eligible for Medicare, you must have Medicare Part A and Part B to have TFL coverage. This includes people who live overseas and people with employer-sponsored health plans.
If you have employer-sponsored health coverage, you can delay Medicare Part B and sign up during a Special Enrollment Period. If you choose to rely solely on employer-sponsored coverage, sign up for Medicare Part B the month before you retire or lose employer-sponsored coverage. This ensures your Medicare Part B and TRICARE coverage under TFL starts as soon as your other coverage ends.
If you don’t sign up for Medicare Part B during your Initial Enrollment Period and you aren’t eligible for a Special Enrollment Period, you can also sign up during the Medicare General Enrollment Period.
To learn more about signing up for Medicare Part B, check the TRICARE For Life Handbook.
Q: Will my family’s TRICARE annual enrollment fee change when I become eligible for Medicare?
A: TFL doesn’t have an annual enrollment fee. But if you have family members enrolled in a TRICARE Prime or TRICARE Select plan, your family’s enrollment fee may change:
- The fee changes to the single rate if you have only one family member enrolled in TRICARE Prime or TRICARE Select.
- Your enrollment fee will stay the at the family rate if you have two or more family members enrolled in TRICARE Prime or TRICARE Select.
To learn more about enrollment fees, use the Compare Costs tool. You can also call your TRICARE contractor.
Q: If my sponsor passes away, does this affect my eligibility for TFL?
A: If a sponsor dies after they retired from active duty, their spouse stays eligible for TRICARE unless they remarry (unless the new spouse is a retired service member). When the surviving spouse has Medicare Part A and Part B, they’ll have TFL.
Q: How can I learn more about TFL?
A: There are many resources to help you learn about TFL. Here are a few places to get started:
- Check out the TRICARE For Life Handbook, TRICARE and Medicare Turning Age 65 Brochure, and TRICARE and Medicare Under Age 65 Brochure.
- Watch the latest TFL webinar.
- Listen to the “TRICARE For Life 101” series of the TRICARE podcast.
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Courtesy Story
Defense Health Agency