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Medicare vs. TRICARE: Which Government Health Plan is Better?

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Summary: For many military retirees, Medicare and TRICARE will work together to give you your health benefits.

Is Medicare or TRICARE better for retired or active-duty military members? For many military retirees, Medicare and TRICARE will work together to help reduce or eliminate many out-of-pocket health costs and give you convenient access to good medical services.

Medicare vs TRICARE: how are they different?

Original Medicare consists of Part A and Part B. Medicare Part A mostly focuses on inpatient (hospital) care, and Medicare Part B mostly focuses on outpatient services. Both Medicare Part A and B will generally cover a broad range of healthcare needs. However, with Original Medicare, you will often still have some out-of-pocket healthcare costs in the form of coinsurance, deductible, or copay expenses.

Most Americans qualify for premium-free Medicare Part A at age 65 and should enroll as soon as they qualify. On the other hand, most Medicare recipients pay a monthly premium for Medicare Part B. While the majority of qualified people also enroll in Medicare Part B, the choice to delay this part of Original Medicare could depend upon other coverage that you have.

In contrast to Medicare, TRICARE serves as the umbrella name for the health plans for both retired and active military people in the United States. Some parts of the plan also cover family members and survivors of current or former military members. TRICARE for Life provides a Medicare-wraparound plan for people who are eligible for both TRICARE and Medicare when they are already retired.

Do you need both Medicare and TRICARE?

Since most people need to pay monthly premiums for Medicare Part B, you might wonder if you need Medicare if you already have TRICARE. It depends mostly upon your military status:

  • If you’re still on active duty or qualified for TRICARE through an active family member, you can typically delay enrollment in Medicare Part B, according to the TRICARE site.
  • TRICARE also states that you need to enroll in both Medicare Part A and B if you’re retired and enrolled in TRICARE for Life.
  • Medicare Part D provides prescription drug insurance. While you don’t absolutely need Medicare Part D to enroll in TRICARE for Life, you do need to have prescriptions covered to get help to pay for medications and to avoid a late-enrollment penalty.

Note that your covered spouse should also enroll in Medicare Part A and B upon turning 65. If your spouse hasn’t turned 65 yet, he or she can remain on TRICARE. Likewise, when spouses turn 65 first, they should enroll in Medicare Part A and B along with TRICARE for Life.

How TRICARE coordinates benefits with Medicare

TRICARE works with Medicare to help reduce your medical expenses. The exact way TRICARE coordinates benefits with Medicare depends upon the TRICARE program you are currently enrolled in.

This briefly highlights the Medicare and TRICARE coordination of benefits:

  • If you’re still active in the military, TRICARE will generally pay for Medicare-covered healthcare services. TRICARE also sometimes pays for healthcare costs that Medicare doesn’t fully cover.
  • Retired members of TRICARE for life should expect Medicare to pay first for anything that it covers. In this case, TRICARE for Life usually works more like supplemental insurance. TRICARE makes an exception to this and pays for services from military or federal healthcare facilities, even if they would be covered by Medicare at another facility.

Congrats on being eligible for both Medicare and Tricare. Now you can reap the rewards for your years of service.

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