• Aug 12, 2020
  • 6:04 AM

Health Insurance

Benefit Category: Federal


Managed by the Defense Health Agency (DHA) under the policy guidance and direction of the Assistant Secretary of Defense (Health Affairs) (ASD[HA]). The DHA manages the TRICARE budget, executes TRICARE policies and oversees the entire TRICARE health program. Military retirees are eligible for TRICARE For Life. TRICARE For Life offers secondary coverage to Medicare for all beneficiaries who have both Medicare Parts A and B.

Using TRICARE For Life at Veterans Affairs Facilities

Veterans Affairs (VA) facilities, even if they are in the TRICARE network, are not Medicare-authorized providers.
  • By law, Medicare cannot pay for care at a government facility. When you use TRICARE For Life to receive care for a non-service-connected condition from a VA facility, even when the VA facility is in the TRICARE network, the VA cannot bill Medicare.
  • By law, when you seek care from a non-Medicare provider, such as the VA, TRICARE can pay only up to 20 percent of the TRICARE allowable charge.
TRICARE and the VA recommend that you get care for your service-connected disability at a VA facility. For all of your other care, you should consider all of your options, including using a Medicare-certified provider. When using Medicare providers, you typically have no out-of-pocket costs for services covered by both Medicare and TRICARE. If you use your TRICARE For Life benefit at a VA facility and have no other VA benefit to cover those costs, you will have to pay the remaining balance after TRICARE pays its 20% of the TRICARE-allowable charge. You may wish to talk to your VA facility about your VA options, including how VA claims are processed if you are entitled to Medicare or have other health insurance.

Retired Reserve Members and Families

Retired Reserve members and their families may qualify for different options based on the age of the sponsor. At any time, you can enroll in the TRICARE Retiree Dental Program. It’s separate from TRICARE’s health plans.

Health Plan Options

Under Age 60

Upon retirement and when you are under age 60: You and your family may qualify to purchase TRICARE Retired Reserve. If you don’t purchase TRICARE Retired Reserve, you don’t qualify for any other TRICARE health plan options until you turn age 60 and begin receiving retirement pay. If you purchase TRICARE Retired Reserve and you have adult children who “age out” at 21 (or 23 if attending college), they may qualify to purchase TRICARE Young Adult

Age 60 and Older

When you turn 60 and begin receiving retired pay, you and your family become eligible for the same TRICARE health benefits as all other retired service members. Your health plan options are different based on where you live: In the United States, you can use: Outside of the United States, you can use: Additionally, adult children who “age out” at 21 (or 23 if attending college) may qualify to purchase TRICARE Young Adult. Please review this fact sheet and visit the website for more information. Sign up for TRICARE e-mail updates at www.tricare.mil/subscriptions. Connect with TRICARE on Facebook and Twitter at www.facebook.com/tricare and www.twitter.com/tricare Listen to TRICARE’s weekly podcast for a recap of this week’s TRICARE news. Or subscribe to get Podcasts via email.

Related Resource(s)

TRICARE VA Dental Insurance Program (VADIP)