What changes at 65
| Before 65 (TRICARE Prime) | At 65 (TRICARE For Life) | |
|---|---|---|
| Who pays first | TRICARE | Medicare, then TRICARE |
| Doctors | Primary care manager and TRICARE network, with referrals | Any provider who accepts Medicare |
| Enrollment fee | Prime enrollment fees for most retirees | No TFL fee; you pay the Part B premium |
| Prescriptions | TRICARE pharmacy | TRICARE pharmacy continues; Part D optional |
In Ohio that usually means moving from care managed through a military treatment facility such as Wright-Patterson Medical Center, or a TRICARE network, to Original Medicare doctors and hospitals anywhere in the state, with TFL as second payer.
Your 65th birthday timeline
- About 4 months before. If you don't already get Social Security, apply for Medicare Part A and Part B through Social Security (1-800-772-1213 or ssa.gov). If you already get Social Security benefits, you're enrolled automatically.
- No later than the month before your birth month. TRICARE advises having Part B in place by then (two months before if your birthday is on the first) so TFL starts without a break.
- When your Medicare card arrives. Make sure DEERS shows your Medicare coverage, and show both cards to your providers.
- Within 90 days of your Medicare start date. Make any TRICARE plan changes for family members under 65.
- Review drug coverage. TRICARE pharmacy coverage is creditable, so Part D is optional and there's no late penalty for skipping it.
If you're eligible for premium-free Part A and don't have Part B, you lose TRICARE coverage, except prescriptions at military pharmacies. Signing up late can also mean a Part B penalty of 10% for each 12-month period you went without it.
Exceptions
- Active duty family members with Part A can enroll in TRICARE Prime regardless of age if they live in a Prime Service Area, and don't need Part B while the sponsor serves. They should sign up for Part B before the sponsor's active duty ends.
- Still working with job-based coverage? You can delay Part B, but sign up before that coverage ends so TFL starts right away.
- No premium-free Part A? If neither you nor your spouse qualifies, you don't need Part B to keep TRICARE and can keep Prime or Select after updating DEERS with Social Security's notice.
More in our guide to veterans, TRICARE and Medicare in Ohio and turning 65 in Ohio. If you'd like help understanding your Medicare choices alongside TFL, you can request a call from a licensed insurance agent.
Related questions
Do I need Part B with TRICARE For Life?
Who must keep it.
Does TRICARE For Life work with Medicare?
How the bill is split.
Can I use the Wright-Patterson pharmacy?
Military pharmacies after 65.
Sources
More questions in this guide
- Can military retirees on Medicare use the Wright-Patterson pharmacy?
- Can veterans in Ohio have Medicare Advantage and VA care?
- Do I need Medicare if I have VA health care in Ohio?
- Do I need Medicare Part B to keep TRICARE For Life?
- Does TRICARE For Life work with Medicare in Ohio?
Part of the guide: Veterans, TRICARE and military retirees in Ohio: how Medicare fits · All questions
Frequently asked questions
What happens to my spouse's TRICARE Prime when I turn 65?
Nothing changes for a spouse or child under 65. They keep their own TRICARE plan. TRICARE says family members can change plans within 90 days of the Medicare-eligible family member's Medicare start date.
Can I stay in TRICARE Prime after 65?
Not as a retiree or retiree's family member with Medicare Part A and Part B: TRICARE says you're covered by TFL and can't enroll in other TRICARE health plans. Active duty family members who have Part A may keep Prime if they live where it's offered.
What if I'm under 65 with Medicare from a disability?
If you have Part A and Part B, you can stay in TRICARE Prime (or the Uniformed Services Family Health Plan) if you qualify. If you don't enroll in Prime, you're covered by TFL.
Medicare in your Ohio county
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