TRICARE And TRICARE For Life

 

TRICARE (Before Age 65)

TRICARE is health coverage for:
 • Active duty service members
 • Military retirees
 • Eligible spouses and dependents

If you are under age 65:
 • ❌ Medicare Advantage is usually not relevant
 • ✔️ TRICARE is your primary coverage

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TRICARE For Life (TFL) — Age 65+

How TRICARE For Life Works

TRICARE For Life is wraparound coverage once you have:
 • Medicare Part A
 • Medicare Part B

Coverage order:
 • Medicare (Original Medicare or a Medicare Advantage plan) pays first
 • TRICARE For Life pays second

Most out-of-pocket medical costs are typically covered.

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Can You Lose TRICARE For Life If You Enroll in a

Medicare Advantage (Part C) Plan?

Short answer:
👉 No. You do not lose TRICARE For Life just because you enroll in a Medicare Advantage plan.

Here’s the clear explanation you can rely on.

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✅ What Is True

Enrolling in a Medicare Advantage (Part C) plan:
 • Does not cancel or remove TRICARE For Life
 • Does not change your TRICARE eligibility

You keep TRICARE For Life as long as you:
 • Remain eligible for TRICARE
 • Stay enrolled in Medicare Part A and Part B
 • Keep your DEERS information current

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🚫 What Can Cause You to Lose TRICARE For Life

You may lose TFL if:
 • ❌ You are not enrolled in Medicare Part B
 • ❌ You disenroll from Medicare Part B
 • ❌ Your DEERS information is not up to date
 • ❌ You lose TRICARE eligibility due to a status change

👉 Medicare Advantage enrollment alone does NOT affect TFL eligibility.

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How Coverage Works With Medicare Advantage + TRICARE For Life

 • Medicare-covered services are processed through your Medicare Advantage plan
 • TRICARE For Life pays second for TRICARE-covered services
 • TRICARE benefits do not increase or change
 • Some providers may require Medicare Advantage network participation

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Does TRICARE For Life Include Prescription Drug Coverage?

✅ Yes — Through the TRICARE Pharmacy Program

If you have TRICARE For Life, you are automatically covered under the TRICARE Pharmacy Program, regardless of whether you have Original Medicare or a Medicare Advantage plan.

Prescription Coverage Tiers

TRICARE covers:
 • Generic drugs
 • Brand-name formulary drugs
 • Non-formulary drugs (higher cost-sharing)
 • Specialty medications (specific rules apply)

Coverage depends on:
 • Whether the drug is on the TRICARE formulary
 • Where and how the prescription is filled

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Where Prescriptions Can Be Filled (Very Important)

Military Pharmacies (Lowest Cost)
 • Often $0 copay
 • Available at Military Treatment Facilities (MTFs)

TRICARE Mail Order Pharmacy
 • Lower copays
 • 90-day supplies
 • Enrollment required

Retail Network Pharmacies
 • Covered with copays
 • Costs vary by drug tier

Important limitations:
 • Prior authorization may be required
 • Step therapy may apply
 • Quantity limits may apply
 • Non-formulary drugs cost more
 • Some drugs may not be covered

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TRICARE vs. Medicare Part D (Critical Rule)

If you have TRICARE For Life:
 • ❌ You do not need Medicare Part D
 • ✔️ TRICARE drug coverage is creditable
 • ✔️ Enrolling in Part D is optional, not required

Many Veterans choose not to enroll in Part D.

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Do You Still Get Medicare Advantage Extra Benefits?

(Giveback, OTC, Dental, Etc.)

Part B Premium Giveback

✅ Yes, if your plan offers it
 • Applied to your Social Security check
 • Does not require using plan doctors
 • May take 1–3 months to appear

OTC Allowance

❌ Not automatic
Usually requires:
 • Plan activation
 • Using the OTC card or catalog
 • Sometimes a health assessment

Unused benefits may expire.

Dental, Vision, Hearing

❌ No, unless you:
 • Use the plan’s network providers
 • Follow authorization rules

VA care does not activate these benefits.

Transportation, Meals, Wellness

❌ No, unless:
 • You use plan medical services
 • You meet plan-specific rules

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Why This Happens (Plain English)

 • VA care is separate from Medicare
 • Medicare Advantage benefits activate only when the plan is used
 • Using VA providers exclusively = the plan remains idle

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What Does “Using the Medicare Advantage Plan” Mean?

To access most benefits, you must:

Stay Actively Enrolled (Required)

 • Keep the plan
 • Keep Medicare Part A & B
 • Pay any required plan premium

✅ Keeps plan active
❌ Does not unlock extra benefits by itself

Complete Plan Activation Steps

Often required:
 • Welcome call
 • Health Risk Assessment (HRA)
 • Account or OTC card activation

Use In-Network Providers

 • Dental → plan dental network
 • Vision → plan vision provider
 • Hearing → plan-approved vendor

VA doctors do not count.

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If You Enroll in Medicare Advantage and Only Use VA Doctors

Short answer:
👉 Nothing changes at the VA.

How Billing Works

 • VA care is billed under VA eligibility
 • Medicare Advantage is not billed
 • TRICARE and CHAMPVA are not billed
 • Your Medicare Advantage plan sits in the background

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CHAMPVA vs. TRICARE For Life (Important Distinction)

TRICARE For Life:
 • Applies to non-VA care
 • Requires Medicare Parts A & B
 • Does not apply to VA care

CHAMPVA:
 • Applies to non-VA providers
 • Requires Medicare Part B (when applicable)
 • Does not apply to VA care

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Potential Downsides to Know

 • You may pay for a plan you never use
 • Prior authorization may apply outside the VA
 • VA prescription coverage remains separate

If you only use VA doctors, enrolling in Medicare Advantage does not affect VA care and provides no added benefit unless you use non-VA providers.

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Official Resources

TRICARE Pharmacy Program:
https://www.tricare.mil/pharmacy

TRICARE For Life:
https://www.tricare.mil/tfl

TRICARE Phone:
📞 1-866-773-0404

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Important Information & Disclosure

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Anthony’s Healthcare provides educational information to help explain how Medicare, Medicare Advantage, TRICARE, TRICARE For Life, CHAMPVA, and VA health care may interact. We are not affiliated with or endorsed by the U.S. Department of Veterans Affairs (VA), the Department of Defense (DoD), Medicare, TRICARE, CHAMPVA, or any government agency.

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These programs are separate and have different rules. Eligibility, coverage, coordination of benefits, authorization, and payment decisions are determined by the appropriate administering agency.

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Medicare Advantage benefits, including premium reductions and supplemental benefits, are plan-specific, not guaranteed, and may require activation or provider use. Information provided is for educational purposes only and does not guarantee eligibility, coverage, benefits, cost savings, or enrollment.

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Veterans should rely on the VA, TRICARE, or the appropriate agency for official benefit determinations and authorization of care.