How TFL and Medicare work together
- Medicare pays first for services Medicare covers, at any provider that accepts Medicare.
- TFL pays second for services TRICARE covers, so you generally owe nothing for care both programs cover.
- You don't file claims with Original Medicare. Medicare and TRICARE coordinate benefits for you.
- If Medicare doesn't cover a service, your provider can file the claim directly with the TFL claims contractor.
You don't sign up for TFL. Coverage starts when your Part A and Part B take effect.
Why Part B matters
TFL requires Part B. If you sign up for Part B late, Medicare's penalty of 10% for each full 12-month period without Part B lasts as long as you have it. Active duty service members and active duty family members can delay Part B while the sponsor is on active duty and sign up during a Special Enrollment Period; TRICARE advises signing up before the sponsor retires to avoid a gap.
Using TFL in Texas
- Civilian doctors: any Medicare-participating or non-participating provider works with TFL. Providers who have opted out of Medicare can leave you with large bills.
- Military hospitals and clinics: TFL beneficiaries may get care at a military hospital or clinic in Texas if space is available.
- Prescriptions: TRICARE Pharmacy Home Delivery sends up to a 90-day supply, and military pharmacies fill prescriptions too. For pharmacy questions, call the TRICARE Pharmacy Program at 1-877-363-1303.
- Medigap and other insurance: TFL already pays your Original Medicare out-of-pocket costs for TRICARE-covered services. The TFL handbook suggests evaluating carefully whether to keep a Medicare supplement, a Medicare Advantage plan or other insurance.
Get help
Call the TRICARE For Life claims contractor at 1-866-773-0404 (TDD 1-866-773-0405). A licensed insurance agent with Benefits Life can explain how a Medicare Advantage plan would fit with TFL, from the companies they work with, at no cost to you, at (512) 265-6565, TTY 711. See veterans, TRICARE and military retirees.
Related questions
Do I need Part B if I'm still working?
Employer coverage and Part B timing.
How do I sign up for Medicare in Texas?
Applying through Social Security.
Medicare phone numbers in Texas
TRICARE, Medicare and more.
Sources
- TRICARE — TRICARE For Life
- TRICARE For Life Handbook
- TRICARE — Medicare-eligible active duty family members
- Medicare.gov — Which insurance pays first (TRICARE and VA)
Frequently asked questions
Do I need Part B to keep TRICARE at 65?
Yes. TRICARE says you need both Part A and Part B for TFL, and you must keep paying the Part B premium, which is $202.90 a month in 2026 for most people. If you don't have Part B, you lose TRICARE coverage. Active duty family members have a special rule while the sponsor is on active duty.
Can I join a Medicare Advantage plan and keep TRICARE For Life?
Yes. TRICARE says you can choose a Medicare Advantage plan and won't lose TFL, but you'll generally need to use the plan's network, may pay a plan premium, and may need to file your own claims with the TFL claims contractor to be reimbursed for copayments.
Do I need a Medicare Part D plan with TFL?
No. TFL includes prescription coverage through the TRICARE Pharmacy Program. The TFL handbook notes some Part D plans may cover drugs TFL doesn't, so some people buy one anyway. Having TRICARE pharmacy coverage counts as creditable, so you won't owe a Part D late penalty if you join later.
Does Medicare pay for care at a VA facility?
No. VA providers can't bill Medicare. If you use a VA provider for care not related to a service-connected condition, TFL pays as second payer, up to 20% of the TRICARE-allowable amount, and you may owe the rest.
Medicare in your Texas county
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