FALLS CHURCH, Va. –
Did you know that
Medicare Part A and Part B costs change each year on Jan. 1? If you have
TRICARE For Life or you’ll
become eligible for Medicare this year, now is a good time to review these costs.
“Generally, your costs will depend on if the care you get is covered by both Medicare and TRICARE, by only one of them, or by neither,” said Anne Breslin, TRICARE For Life program manager at the Defense Health Agency. “If both Medicare and TRICARE cover the care, you’ll have no out-of-pocket expenses.”
Keep reading to learn more, including costs related to having TFL coverage and how TFL minimizes what you pay for health care services.
What is TRICARE For Life?
TFL is Medicare-wraparound coverage if you’re TRICARE-eligible and you’re eligible for Medicare Part A. You must have Medicare Part A and Part B to have TFL, regardless of your age or where you live.
Enrollment fees and premiums
TFL has no enrollment fees or premiums. However, you need to pay Medicare premiums to have TFL.
- Medicare Part A premiums are financed through payroll deductions while you’re working.
- Medicare Part B has a monthly premium based on your income. This premium may change each year. If you receive monthly Social Security retirement or disability benefits, your Part B premium is deducted from these monthly benefits.
Learn more about paying Medicare premiums.
Costs for care covered by both Medicare and TRICARE
Medicare and TRICARE work together to coordinate your benefits. Most health care services are covered by both Medicare and TRICARE.
The type of provider you see will affect your costs:
- When you see a Medicare participating or Medicare non-participating provider, you have no out-of-pocket costs for services covered by both Medicare and TRICARE. Check out Health Plan Costs or the TRICARE For Life Cost Matrix to see examples of these costs for 2026.
- Some providers opt out of Medicare. Medicare doesn’t pay for the services you get from these providers. If you see a provider who has opted out of Medicare, TRICARE pays the amount Medicare would have paid if Medicare had processed the claim. (This is normally up to 20% of the TRICARE-allowable charge.)
Learn more about types of Medicare providers. You can also learn about services Medicare covers and services TRICARE covers.
Costs for care only covered by Medicare
When you get care that’s covered by Medicare only, Medicare processes the claim as the primary payer and pays the Medicare-allowed amount. TRICARE pays nothing. You’re responsible for the Medicare deductible and cost-share and any remaining billed charges. See the TRICARE For Life Cost Matrix to learn more about 2026 Medicare deductibles.
Costs for care Medicare doesn’t cover
Medicare doesn’t cover all health care services. Medicare also doesn’t cover care you get outside the U.S. and U.S. territories, as described in the TRICARE For Life Handbook.
In these cases:
During a calendar year (Jan. 1–Dec. 31), the most you pay for TRICARE-covered services and supplies is your TFL catastrophic cap.
- The TFL catastrophic cap is $3,000.
- When you meet your catastrophic cap, you don’t pay anything for the rest of the calendar year for services and supplies that are medically necessary and covered by TRICARE.
Costs for care not covered by Medicare or TRICARE
When you get care that isn’t covered by Medicare or TRICARE, you’re responsible for the entire bill. This may be more than the Medicare-approved amount or TRICARE-allowable amount.
Pharmacy costs
TFL includes prescription drug coverage through the TRICARE Pharmacy Program.
Go to Pharmacy Costs to see TRICARE Pharmacy Program costs for 2026 and 2027. These costs are based on who you are, the category of drug you need, and where you fill your prescription.
Learn more
There’s a lot to learn about Medicare and TFL. Here are some resources to get you started.
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