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TRICARE for Life and Medicare Part D

How TRICARE for Life pharmacy coverage works with Medicare — and why most military retirees don't need Part D.

Quick answer for military retirees

TRICARE for Life (TFL) prescription coverage is creditable for Medicare Part D. Most military retirees with TFL don't need to enroll in Part D — TFL pharmacy benefits are typically excellent. However, you must enroll in Medicare Part B to keep TFL eligibility.

How TRICARE for Life works with Medicare

TRICARE for Life (TFL) is the wraparound coverage available to retired military service members, their spouses, and survivors who have Medicare and are TRICARE-eligible. TFL automatically becomes your secondary insurance to Medicare on the first day you have both Medicare Parts A and B. There is no enrollment fee for TFL.

TRICARE pharmacy benefits are creditable for Medicare Part D, meaning the drug coverage is at least as good as standard Part D. As a result, most retirees with TFL don't need to enroll in Part D.

You must enroll in Medicare Part B to keep TRICARE for Life

This is the most important rule for military retirees: you must enroll in Medicare Part B when you become eligible (typically at age 65) to maintain TFL eligibility. If you don't enroll in Part B, you will lose TRICARE coverage entirely. The Part B premium is the only ongoing cost for TFL coverage.

How TFL pharmacy benefits work

TRICARE pharmacy is administered through the TRICARE Pharmacy Benefit, which uses Express Scripts as its pharmacy benefit manager. There are four ways to fill prescriptions:

1. Military pharmacies (military treatment facilities)

Cost: $0 for most medications. The cheapest option for retirees who live near a military pharmacy.

2. TRICARE Pharmacy Home Delivery (Express Scripts mail-order)

Cost: $0 for generics, $13 for brand-name (preferred), $43 for non-preferred brand for a 90-day supply (2026 rates may vary). The most cost-effective option for maintenance medications.

3. Retail network pharmacies

Cost: $14 for generics, $38 for brand-name (preferred), $76 for non-preferred brand for a 30-day supply (2026 rates may vary). Used for short-term prescriptions.

4. Non-network pharmacies

Cost: Significantly more expensive. You typically pay full price upfront and submit for reimbursement.

Should you enroll in Part D if you have TFL?

For most TRICARE for Life beneficiaries, the answer is no. TFL pharmacy coverage is comprehensive and the costs are typically lower than what you'd pay through a Part D plan. Adding Part D would mean paying an additional monthly premium without getting much benefit.

You probably don't need Part D if:

  • You have TFL with full TRICARE pharmacy benefits
  • Your medications are covered through TRICARE
  • You can use military pharmacies, mail-order, or retail network pharmacies
  • Your TRICARE pharmacy copays are reasonable

Rare cases when Part D might help:

  • You take expensive specialty medications that aren't well-covered by TRICARE
  • You qualify for Extra Help, which can make Part D essentially free
  • You frequently use non-network pharmacies that TRICARE doesn't cover well

Even in these cases, you should compare carefully. TRICARE benefits are generally hard to beat.

How TFL and Part D coordinate (if you have both)

If you have both TFL and Part D, the coordination is similar to other secondary insurances:

  • Part D pays first for prescriptions
  • TFL pays second, picking up some costs that Part D doesn't cover
  • You'd pay the lower of the two cost-sharing structures, depending on the specific drug and pharmacy

However, having both adds complexity and an additional Part D premium that's usually unnecessary given TRICARE's strong drug benefits.

USFHP and TRICARE Select for retirees

Some military retirees enrolled in TRICARE Prime through the US Family Health Plan (USFHP) or TRICARE Select have different coordination rules with Medicare. Generally, once you turn 65 and become Medicare-eligible, you must transition to TFL — though there are exceptions for people in USFHP. Contact TRICARE at 1-800-444-5445 for your specific situation.

TRICARE for surviving spouses and dependents

Surviving spouses and dependent children of deceased service members may also be eligible for TFL or other TRICARE programs. Their Medicare and Part D coordination follows the same general rules — TRICARE pharmacy benefits are creditable, and Part D enrollment is optional.

If you delay Part D and want to enroll later

Because TFL is creditable, you can enroll in Part D in the future without a late enrollment penalty:

  • Annual Enrollment Period (October 15 – December 7)
  • Special Enrollment Period if you involuntarily lose TFL pharmacy benefits

Keep documentation of your TFL coverage. Each year, TRICARE provides a notice confirming creditable coverage that you can save in case you ever need to prove it.

If you do consider adding Part D alongside TFL

Although it's rarely beneficial, military retirees who want to consider adding Part D should run their medications through the comparison tools first. PlanMatch compares Part D plans by your specific drugs, or a licensed Medicare agent familiar with military benefits coordination can show you whether the math works for your situation.

Get personalized help

Military retirees navigating Medicare have several free resources:

Frequently asked questions

Do military retirees need Medicare Part D if they have TRICARE for Life?

Most don't. TRICARE for Life pharmacy benefits are creditable for Medicare Part D, meaning they're at least as good as standard Part D. TRICARE pharmacy is typically more comprehensive than standalone Part D, so adding Part D rarely makes financial sense.

Do I have to enroll in Medicare Part B to keep TRICARE for Life?

Yes — this is critical. You must enroll in Medicare Part B when you become eligible to maintain TFL coverage. If you don't enroll in Part B, you lose TRICARE coverage entirely. The Part B premium is the only ongoing cost for TFL.

Is TRICARE pharmacy creditable for Part D?

Yes. TRICARE pharmacy benefits — including TFL — are considered creditable coverage for Medicare Part D. You can delay enrolling in Part D without facing a late enrollment penalty as long as you maintain continuous TRICARE coverage.

How does TRICARE pharmacy work for retirees?

TRICARE retirees can fill prescriptions four ways: military pharmacies (free for most drugs), TRICARE Home Delivery via Express Scripts (lowest cost for 90-day supplies), retail network pharmacies (30-day supplies), and non-network pharmacies (most expensive, requires reimbursement claims).

What happens if I lose TRICARE pharmacy benefits?

If you involuntarily lose TRICARE pharmacy benefits, you qualify for a Special Enrollment Period to enroll in Medicare Part D without a late enrollment penalty. You generally have 2 months from the date of the coverage loss to enroll.

Ready to take the next step?

There are several free ways to get help with your Medicare coordination questions:

You can also visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227)