Benefit Fact Sheet
TRICARE for Life (TFL) is TRICARE's Medicare-wraparound coverage available worldwide to TRICARE beneficiaries who are also entitled to Medicare. Essentially, TFL acts as a supplement to Medicare Part A and B, there are no special enrollment procedures or TRICARE premium payments.
DFAS will provide IRS Form 1095-C to all U.S. military members, and IRS Form 1095-B to all retirees, annuitants, former spouses and all other individuals having TRICARE coverage during all or any portion of tax year 2023. An IRS Form 1095 documents you (and your family members, if applicable) have the minimum essential coverage. These forms will document the information that DFAS will provide to the IRS on yourself and your authorized family members. According to the IRS, these forms are not required to prepare or file income tax returns but will be available via myPay no later than 31 January 2024.
Retired National Guard Soldiers who have Medicare Part A and B and in receipt of retired pay are eligible for TFL, as are their dependent family members, surviving spouses and certain former spouses who have Medicare Part A & B. "Gray-area" retirees are not eligible for TFL, but may be eligible for TRICARE Retired Reserve.
Dependent parents and parents-in-law are not eligible for TRICARE for Life. When TRICARE beneficiaries become entitled to Medicare Part A and B (1) on the basis of age (65), (2) disability, or (3) end-stage renal disease, they are eligible for TRICARE for Life (TFL). Note: In order to be covered under TFL, beneficiaries must be enrolled in Medicare Part B and have a current military ID card.
Beneficiaries entitled to Medicare Part A who decline Medicare Part B coverage will lose TRICARE eligibility.
The key to TRICARE eligibility depends on enrollment in the Defense Enrollment Eligibility Reporting System (DEERS), which will indicate the dates of eligibility. All uniformed services sponsors (active, reserve or retired) should ensure that their family status (marriage, death, divorce, new Child, etc.) and residential address are current in DEERS at all times.
TRICARE Benefits change frequently so be sure to reference the TRICARE site at https://tricare.mil/
Using TFL with Medicare and Other Health Insurance (OHI):
If you have other health insurance, such as a Medicare supplement or an employer-sponsored health plan, you can use TRICARE For Life as long as you have both Medicare Parts A and B.
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If you have employer-sponsored insurance based on current employment, the other health insurance pays first, Medicare pays second and TRICARE pays last
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In this case, your provider will file your health care claims
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If you have OHI that is not based on your or a family member’s current employment, Medicare pays first, the OHI pays second and TRICARE pays last
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In this case, you must file a claim with the TFL contractor. Submit a paper claim to WPS along with a copy of:
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your provider's itemized bill
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the Medicare Summary Notice, and
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the explanation of benefits from all other health insurances.
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Your claim must be filed within one year from the date of care. For more information, visit the WPS website.
For exact copayments for inpatient and outpatient services, please visit: https://tricare.mil/Publications/Costs
NOTE: Retirees eligible for TFL will face higher outpatient costs at VA hospitals and clinics for non-service-connected care as Medicare will not pay for services at VA facilities. Please visit: https://tricare.mil/Plans/HealthPlans/TFL/TFL_VA
Type of Service |
Medicare Pays |
TRICARE Pays |
You Pay |
Covered by TRICARE and Medicare |
Medicare-authorized amount |
Remaining amount |
Nothing |
Covered by Medicare only |
Medicare-authorized amount |
Nothing |
Medicare deductible and cost-share |
Covered by TRICARE only |
Nothing |
TRICARE-allowable amount |
TRICARE deductible and cost-share |
Not covered by TRICARE or Medicare |
Nothing |
Nothing |
Billed charges ( which may exceed the Medicare- or TRICARE allowable amount) |
To learn more about what TRICARE covers, please visit: https://tricare.mil/CoveredServices
To learn more about what Medicare covers, please visit: https://www.medicare.gov/what-medicare-covers
For more information, please visit the TRICARE for Life webpage maintained by the TRICARE Management Activity:
https://tricare.mil/tfl
TRICARE DEERS Information:
https://tricare.mil/DEERS
TRICARE for Life Handbook:
https://tricare.mil/~/media/Files/TRICARE/Publications/Handbooks/TFL_HBK.pdf
Medicare Part A and B information: https://www.medicare.gov/basics/costs/medicare-costs