Turning 65? How to Seamlessly Transition to TRICARE for Life

by | UCMJ | 1 comment

Turning 65 marks a significant milestone in your life, especially when it comes to healthcare coverage. If you’re a military retiree or the spouse of a retiree, you’re likely familiar with TRICARE, the health care program serving Uniformed Service members, retirees, and their families. But what happens to your TRICARE benefits when you hit that 65-year milestone? Navigating the transition can seem daunting, but understanding your options is crucial for maintaining seamless healthcare coverage.

As you approach your 65th birthday, it’s time to explore how TRICARE works with Medicare. You’ll find that your healthcare coverage may shift, and you’ll need to make informed decisions to ensure you’re fully covered. Don’t worry, though; you’re not alone in this journey. This guide will walk you through the essentials of TRICARE for those turning 65, offering clear, knowledgeable advice to help you confidently navigate your healthcare options.

Understanding Tricare When You Turn 65

Transitioning to Medicare at age 65 marks a significant shift in your healthcare journey, especially if you’re a TRICARE beneficiary. Navigating this transition smoothly requires a grasp of how TRICARE and Medicare work together to ensure you don’t miss out on vital healthcare benefits. Primarily, you’ll need to enroll in Medicare Parts A and B to remain eligible for TRICARE benefits, which then become secondary to Medicare.

Key Changes and Requirements

  1. Medicare Enrollment: Mandatory enrollment in Medicare Parts A and B is essential to keep your TRICARE coverage.
  2. TRICARE for Life (TFL): Once you have both Medicare Parts A and B, you automatically qualify for TFL, offering comprehensive coverage by paying for services not covered by Medicare.
  3. Defense Enrollment Eligibility Reporting System (DEERS) Update: Ensure your information is up-to-date in DEERS to avoid any coverage lapses.

Coverage and Costs

  • Costs: While Medicare Part A is premium-free for most, Part B comes with a monthly premium. TFL adds no additional premium, but you’re responsible for Medicare Part B premiums.
  • Coverage: Medicare serves as your primary insurance, covering Medicare-eligible services and items. TFL covers the remaining costs for services covered by TRICARE but not by Medicare, essentially reducing out-of-pocket expenses.

Enrollment Deadlines

To avoid penalties and gaps in your coverage, it’s critical to enroll in Medicare Parts A and B as soon as you’re eligible, preferably during your Initial Enrollment Period (IEP). This period begins three months before your 65th birthday and extends for seven months. Delaying Part B enrollment without having other creditable coverage can lead to lifetime penalties and a potential gap in your healthcare coverage.

By understanding these pivotal aspects of how TRICARE interacts with Medicare when you turn 65, you can ensure a seamless transition and continue receiving the healthcare coverage you’ve earned. Keeping abreast of enrollment deadlines, costs, and coverage changes is paramount to maintaining your health care benefits without interruption.

Changes to Your Coverage at 65

Upon turning 65, a significant transition in your healthcare coverage occurs as TRICARE and Medicare integrate. This integration mandates your enrollment in Medicare Parts A and B to retain your TRICARE benefits, marking a pivotal shift in how your healthcare services are managed and delivered. Reflecting on the changes this transformation brings, it’s essential to grasp the nuances to make the most of your healthcare benefits.

Firstly, with Medicare Part A (Hospital Insurance) and Part B (Medical Insurance), you automatically qualify for TRICARE for Life (TFL). TFL acts as a supplement to Medicare, covering the gaps that Medicare doesn’t, such as deductibles and coinsurance, essentially making your out-of-pocket expenses significantly lower.

Transitioning to TFL, your healthcare coverage experiences a split in service providers. Medicare becomes the primary payer for your healthcare services, covering hospital stays, doctor visits, and outpatient services. TRICARE steps in as the secondary payer, covering additional costs not fully paid by Medicare, including those associated with prescriptions.

Remember, updating your information in the Defense Enrollment Eligibility Reporting System (DEERS) is crucial to ensure smooth coverage. Without current information in DEERS, you risk delays in coverage or even losing your benefits.

Understanding the billing process under this new arrangement is also vital. Providers will bill Medicare first for any healthcare services you receive. Once Medicare has paid its portion, the claim is automatically forwarded to TRICARE for any remaining balances. This seamless process minimizes the hassle for you, but staying informed about claim statuses can prevent unexpected expenses.

Lastly, it’s important to note that enrolling in Medicare Part B after your Initial Enrollment Period could result in late enrollment penalties, increasing your Part B premiums. To avoid these extra costs, ensure timely enrollment as you approach eligibility.

Navigating the changes to your healthcare coverage at 65 requires attention to detail and proactive management of your benefits. By understanding these key changes, you can ensure continued access to comprehensive healthcare services without interruption.

Enrolling in Medicare

Upon reaching the age of 65, enrolling in Medicare is paramount for maintaining your TRICARE benefits, with a clear emphasis on both Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). This enrollment process serves as the cornerstone for transitioning to TRICARE for Life (TFL), which operates as a supplementary coverage to Medicare.

Steps to Enroll in Medicare

  1. Initiate Enrollment at 65:
    Begin by enrolling in Medicare Parts A and B as you approach your 65th birthday. Medicare provides a seven-month Initial Enrollment Period (IEP), which includes the three months before your birthday month, your birthday month, and the three months after.
  2. Visit the Social Security Website:
    Complete your Medicare enrollment through the Social Security website or by visiting a local Social Security office. Online enrolment offers a streamlined process, accessible at your convenience.
  3. Review Your Enrollment Status:
    If you’re already receiving Social Security or Railroad Retirement Board benefits, you’ll be automatically enrolled in Medicare Parts A and B. Otherwise, you must proactively enroll to avoid gaps in your coverage.

After Enrollment

After enrolling in Medicare, updating your information in the Defense Enrollment Eligibility Reporting System (DEERS) is essential. This step ensures that your TRICARE eligibility reflects your Medicare status, facilitating seamless coverage as TRICARE for Life kicks in.

Late Enrollment Penalties

Neglecting to enroll in Medicare Part B at 65 can lead to late enrollment penalties, increasing your Part B premium by 10% for each 12-month period you were eligible but didn’t enroll. These penalties can substantially impact your healthcare costs, underscoring the importance of timely enrollment.

Enrolling in Medicare at age 65 is a critical step for those covered under TRICARE, safeguarding continuous healthcare coverage and facilitating a smooth transition to TRICARE for Life. Being proactive, understanding the enrollment windows, and promptly updating DEERS with your Medicare information will ensure you avoid any potential penalties and enjoy uninterrupted healthcare services.

Tricare for Life (TFL) Explained

Transitioning to Tricare for Life (TFL) at age 65 marks a significant change in your healthcare coverage. As a wraparound to Medicare, TFL serves as secondary insurance, covering costs that Medicare does not, thereby ensuring comprehensive healthcare.

Eligibility and Enrollment: By enrolling in Medicare Parts A and B, you automatically qualify for TFL. There’s no separate application for TFL; enrollment in Medicare triggers your TFL benefits. Importantly, ensure your information is accurate in the Defense Enrollment Eligibility Reporting System (DEERS) to avoid any benefits disruption.

Coverage and Costs: TFL covers a wide range of healthcare services, including hospital stays, outpatient services, and prescription drugs. For services covered by both Medicare and TFL, Medicare pays first, and TFL covers the remaining eligible expenses, often leaving you with minimal out-of-pocket costs. Notably, TFL does not require a monthly premium, but you must pay Medicare Part B premiums.

Overseas Coverage: Unique among healthcare plans, TFL provides coverage worldwide. Whether you live or travel overseas, you’ll have access to healthcare services. Overseas, TFL serves as the primary payer, but it’s crucial to understand the specifics of filing claims and seeking care in different locations.

How TFL Works with Other Insurance: If you have other health insurance besides Medicare and TFL, such as an employer-sponsored plan, the coordination of benefits depends on your specific situation. Typically, Medicare pays first, followed by your other insurance, and TFL covers eligible remaining costs.

Understanding Tricare for Life’s benefits and how it complements Medicare ensures you’re well-equipped to manage your healthcare needs post-65. Always verify your specific plan details and stay informed about updates to make the most of your benefits.

Managing Your Health Care After 65

After transitioning to TRICARE for Life (TFL) and enrolling in Medicare Parts A and B at the age of 65, managing your healthcare becomes a process of understanding and utilizing your benefits effectively. This stage ensures you continue receiving comprehensive coverage, incorporating both Medicare and TRICARE benefits.

  1. Stay Informed: Keep up-to-date with changes in Medicare and TRICARE policies by visiting their official websites or contacting customer service. Policies may change, affecting your coverage and out-of-pocket costs.
  2. Annual Wellness Visits: Make annual wellness visits a priority. Medicare covers these, allowing you to discuss preventative measures and screenings with your healthcare provider to maintain your health.
  3. Understand Your Coverage: Familiarize yourself with what TFL covers as secondary insurance to Medicare. Knowing the specifics can help you avoid unexpected expenses. TFL covers the cost share or deductible not covered by Medicare for Medicare-covered services.
  4. Prescription Benefits: Utilize the TFL prescription drug coverage. TFL works with Medicare Part D, providing comprehensive prescription coverage. Understanding how to get your prescriptions, whether through mail order or a pharmacy, can save you money.
  5. Coordinating With Other Insurance: If you have other health insurance besides TFL and Medicare, know the coordination of benefits. Ensure your healthcare providers are aware of all your coverage to streamline the billing process.
  6. Keep Your Information Updated: Update your DEERS (Defense Enrollment Eligibility Reporting System) information to ensure continuous coverage. Changes in your address, marital status, or other personal information can affect your eligibility.
  7. Seek Preventative Care: Leverage preventive services covered under Medicare Part B, such as flu shots and screenings for cancer and other illnesses. Preventative care helps in managing health effectively, reducing the risk of severe health issues later.

Implementing these strategies allows you to navigate your healthcare efficiently post-65, ensuring you maximize your benefits under TRICARE for Life and Medicare. Managing your healthcare needs with proper knowledge and resources ensures a healthier life during your senior years.


Turning 65 marks a pivotal moment in your healthcare journey, especially if you’re a TRICARE beneficiary. With the transition to TRICARE for Life, alongside Medicare, you’re stepping into a phase where your healthcare needs are significantly supported, but it requires your active participation. Remember, enrolling in Medicare Parts A and B on time is crucial to unlock these benefits without any hitches. This move not only secures your access to a broader spectrum of healthcare services but also ensures you’re covered both domestically and internationally. Keep yourself informed and proactive about your healthcare management. By doing so, you’re not just complying with the requirements; you’re optimizing your health coverage to serve you best in the years to come. Stay ahead by understanding your benefits, coordinating your insurances, and making the most of the preventative care available to you. Your golden years deserve the peace of mind that comes with comprehensive healthcare coverage.



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