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What are my TRICARE For Life Costs?

When you use TRICARE For Life (TFL), you don't pay any enrollment fees, but you must pay Medicare Part B monthly premiums. Your Part B premium is based on your income. For more information visit http://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html or call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).  

What you pay out-of-pocket for care depends on how it's covered. Your out-of-pocket costs are determined by the service you receive and whether or not it's covered by Medicare and TFL. View your Health Care Plan Costs.

How the service is covered What you pay
By both Medicare and TRICARE For Life

*Medicare pays first

*TRICARE For Life pays second

*You pay nothing

By TRICARE For Life but not Medicare

*TRICARE For Life pays first

*Medicare pays nothing

*You pay the TRICARE For Life fiscal year deductible and cost shares

By Medicare but not TRICARE For Life

* Medicare pays first

* TRICARE For Life pays nothing

* You pay the Medicare deductible and coinsurance

Not covered by

Medicare or TRICARE For Life

* Medicare pays nothing

* TRICARE For Life pays nothing

* You pay the entire bill

 

Visit the TRICARE For Life Cost Matrix for more specific TRICARE benefit details.

What is covered?

TRICARE For Life and Medicare cover proven, medically necessary, and appropriate care. TFL has special rules and limitations for certain types of care, and some types of care are not covered at all. TFL policies are very specific about which services are covered and which are not. It is in your best interest to take an active role in verifying coverage. 

For more information on what specific services are covered please visit http://www.tricare.mil/CoveredServices/IsItCovered.aspx

Medicare also has limits on the amount of care it covers and, in some cases TFL may cover these health care services after your Medicare benefits run out. To determine if Medicare covers a specific service or benefit, visit www.medicare.gov or call 1-800-633-4227. 

Exclusions

Some common examples of services that are excluded from TFL coverage are acupuncture, assisted living facility care, chiropractic care, custodial care, elevators or chair lifts, exercise equipment or programs, long term care, nursing homes, and weight loss products. The full list of policy exclusions can be found here: http://www.tricare.mil/CoveredServices/IsItCovered/Exclusions.aspx.