TRICARE For Life (TFL) is Medicare wraparound coverage for TRICARE beneficiaries who have Medicare Part A and Medicare Part B, regardless of age or place of residence. With TFL, beneficiaries have the freedom to seek care from any Medicare-participating or nonparticipating provider, or at a military hospital or clinic on a space-available basis. Enrollment is not required, but beneficiaries must pay Medicare Part B premiums.
Note: TRICARE advises beneficiaries to sign up for Medicare Part B when first eligible to avoid a break in TRICARE coverage. Beneficiaries who sign up later may have to pay a premium surcharge for as long as they have Part B. The Medicare Part B surcharge is 10 percent for each 12-month period that a beneficiary was eligible to enroll in Part B but did not enroll.
After turning 65, beneficiaries who are not eligible for premium-free Medicare Part A on their own or their current, former or deceased spouse’s record may remain eligible for TRICARE Prime or TRICARE Select. They must take the Notices of Award and/or Notices of Disapproved Claim they received from the Social Security Administration (SSA) to the nearest uniformed services ID card issuing facility to update DEERS and get new ID cards.
Note: The term dual-eligible refers to TRICARE and Medicare dual-eligibility and should not be confused with Medicare-Medicaid dual-eligibility.
TFL provides comprehensive healthcare coverage. Beneficiaries have the freedom to seek care from any Medicare-participating provider, from military hospitals and clinics on a space-available basis or from VA facilities (if eligible).
Medicare cannot pay for services received from the VA. Therefore, TRICARE is the primary payer for VA claims, and the beneficiary will be responsible for the TRICARE annual deductible and cost-shares.
Alternatively, the beneficiary may choose to use his or her VA benefit. Neither TRICARE nor Medicare will reimburse costs not covered by the VA.
Medicare-participating providers file claims with Medicare first. After paying its portion, Medicare automatically forwards the claim to TFL for processing (unless the beneficiary has OHI). TFL pays after Medicare and any OHI for covered healthcare services.
TFL beneficiaries must present valid uniformed services identification (ID) cards and Medicare cards prior to receiving services. If a TFL beneficiary’s uniformed services ID card reads “no” under the civilian box, he or she is still eligible to use TFL if he or she has both Medicare Part A and Part B. Copy both sides of the cards and retain the copies for files.
There is no separate TFL enrollment card. To verify TFL eligibility, call the TFL contractor, Wisconsin Physicians Service/TRICARE Dual-Eligible Fiscal Intermediary Contract (WPS/TDEFIC), at (866) 773-0404. Call the Social Security Administration (SSA) at (800) 772-1213 to confirm a patient’s Medicare status.
Note: Beneficiaries age 65 and older who are not eligible for premium-free Medicare Part A may remain eligible for TRICARE Prime (if residing in PSA) or TRICARE Select. See TRICARE and Medicare eligibility in the TRICARE eligibility section for more information. Learn more