Medicare vs TRICARE: Which is Better?

Fact Checked

Medicare and TFL are two government insurance plans that cater to those over 65. By understanding eligibility, cost structures, and how TRICARE works with Medicare, you can take advantage of and maximize their benefits.

What is TRICARE?

TRICARE is a government insurance plan for military and retired military personnel and their families. It brings together the health care resources of the Military Health System such as hospitals and clinics.

TRICARE is designed to utilize both the civilian health system and military medical facilities. The plan includes a network of civilian health care professionals, institutions, pharmacies, and suppliers to provide for its participants’ health care needs.

Who is eligible for TRICARE?

TRICARE eligibility extends to:

  • Uniformed service members and their families
  • Army, Air National Guard/Reserve, and their families
  • Army, Navy, Marine, Air Force, and U.S. Coast Guard Reserves and their families
  • Survivors of deceased sponsors
  • Former spouses
  • Medal of Honor recipients and their families
  • Others registered in the Defense Enrollment Eligibility Reporting System (DEERS)

Beneficiaries include active duty, retired and Guard/Reserve members, and registered family members including spouses and children.

Plans available include TRICARE Prime, TRICARE Extra, and TRICARE Standard. Use this online tool to find a plan that suits your needs.

TFL is the option for people who are:

  • Medicare-eligible uniformed services retirees aged 65 or older
  • Eligible family members and survivors
  • Certain former spouses
  • A person registered in the DEERS
  • A Medal of Honor recipient or eligible family member

How do you enroll in TRICARE?

There are two eligibility requirements to enroll in TFL. One relates to Medicare, and the other relates to the military:

  • If you are enrolled in Original Medicare and registered with the DEERS, you are automatically enrolled in TFL.
  • When you turn 65 and enroll in Medicare A and B, you will be automatically enrolled in TFL, and must remain enrolled in Part A and B to continue TFL.
  • If your Medicare is suspended, TFL will stop. However, you will automatically receive TFL benefits when you reenroll in Medicare.

To check your Medicare status, make an appointment with your local Social Security Administration (SSA) office by calling SSA at (800) 772-1213, or logging in/registering for an online account,

To check your military status, call the Defense Manpower Data Center (DMDC)/Defense Enrollment Eligibility Reporting System DEERS Support Office (DSO) at 1(800) 538-9552 or TTY/TTD 1(866) 363-2883. The fax is 1(800) 336-4416, or you can go to DEERS Online. Once you are registered with DEERS, you can log into or register for milConnect and check your TFL eligibility and get proof of coverage.

How does TRICARE work with Medicare?

TFL is a Medicare wraparound for those who have both Part A and B. Coverage is automatic once enrolled, so there are no enrollment forms and there is no fee for signing up. TFL pays secondary to Medicare when used in the U.S. or its territories.

Because TFL includes drug coverage, you may not want to enroll in a Medicare Supplement Plan or a stand-alone Prescription Drug Plan (PDP). However, a Medicare Advantage Plan (MA Plan) coordinates with TFL and together you can access extra programs.

How Does TRICARE work with Original Medicare?

TFL acts like a hybrid of Medicare Supplement and MA Plans. It is like a supplement plan, so plans pay secondary to Medicare. Like an MA Plan, drug coverage may be included. While in the U.S. and its territories, Medicare pays first and TFL pays secondary. TFL becomes primary when outside the U.S. Because costs are high and coverages are redundant, Supplement (Medigap) Plans are seldom added to TFL coverage.

How Tricare works with Medicare:

  • When you see a provider for medically necessary care that is covered by both Medicare and TRICARE, Medicare will pay primary, TRICARE will pay secondary, and there will be little or no cost to you.
  • If TFL will cover a service but Medicare will not, TRICARE will pay its portion and you will be responsible for any copays and coinsurance.
  • If TRICARE does not cover a procedure but it is covered under Medicare, Medicare will pay its portion and you will be responsible for deductibles, copayments, and coinsurance.

How Does TRICARE work with Medicare Advantage?

TFL can work with Original Medicare or a MA Plan. Understand the coverage and costs of any MA Plan you are considering. Plans are offered regionally, and coverage and costs vary. You will not lose your TFL if you enroll in a MA Plan. However, your MA Plan will become primary for all Medicare-covered services.

How Tricare works with Medicare Advantage:

  • When you see a provider for medically necessary care that is covered by your MA and TFL, your MA carrier will pay primary, TFL will pay secondary, and there will be little or no cost to you.
  • If a service is covered by TFL but not by Medicare, TFL will pay its portion and you will be responsible for any additional costs.
  • If Medicare covers a procedure but TFL doesn’t, your MA carrier will pay its portion and you will be responsible for deductibles, copayments, and coinsurance.

MA Plans may offer coverage that Original Medicare and TFL don’t, like chiropractic, routine dental, hearing, eyewear, and free gym memberships. TFL may cover desired providers that are not in your MA network.

Does Medicare or TRICARE Pay First for Services?

Once a qualifying beneficiary turns 65 and is covered by Medicare, TRICARE coverage automatically transitions to TFL if they qualify. Once on Medicare and TFL, your coverage does not differ between active duty and retirement.

Situation Who Pays First?
Active duty and over 65 Medicare*
Not active duty and over 65 Medicare*
Not active duty receiving care at a military hospital or federal health care provider TFL

*If the service is covered by TFL but not by Medicare, TFL will pay.

How Much Does TRICARE Cost?

For a person who meets the qualification criteria and is enrolled in Medicare A and B, there are no enrollment fees or additional monthly premium charges for TFL. For deductibles, cost shares, and prior authorization rules that apply, download the TRICARE For Life Handbook.

What Is TRICARE Overseas Program?

The TRICARE Overseas Program (TOP) is designed to provide high-quality health care services when living or traveling overseas. TOP benefits are accessed depending on the type of TRICARE Plan you are enrolled in.

For those over 65 and enrolled in Medicare and TFL, the primary payer is TFL, and deductible, cost shares, and prior authorization rules apply. For information about how to obtain local medical care while overseas, referrals and authorizations, enrollment fees (if applicable), and more, download the TOP Enrollment Welcome Letter.

Although Medicare provides little service while overseas, you must continue paying your Part B premiums to remain enrolled in TFL and receive TOP benefits.

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Medicare consultant

Ron Elledge is an accomplished Medicare agent, planner, and author. Elledge earned a bachelor’s degree in Bible theology from International Seminary and spent 30 years in pastoral ministry. He began his current career in insurance with a specialty in Medicare in 2008 and has since authored “Medicare Made Easy: What Expats, Frequent Travelers and You Need to Know” and is often a featured speaker at the International Living conferences. Elledge is a contributor to International Living, supporting Medicare beneficiaries with articles, podcasts, and Q&As.

A licensed seniors market insurance agent in Arizona and New Mexico, Elledge has helped thousands decipher the intricacies of Medicare rules and regulations, enabling them to make educated selections for their health care needs. As a world traveler with his wife, Shelli, Elledge specializes in Medicare for expats and frequent travelers. He’s up to date with Medicare regulations, coverage options, and enrollment protocols and is fervent in his resolve to present trustworthy data on this confusing and often maligned program.

“By obtaining dependable details on how to read their Medicare options, recipients can plan for it correctly and make the best choices,” says Elledge. “These choices often make a huge financial and emotional difference in their futures. When Medicare is correctly utilized, it becomes a powerful financial and medical tool for all who qualify.”

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