Medicare and TRICARE For Life: A Guide for Texas Military Retirees

Texas is home to some of the country's best-known military installations, from Joint Base San Antonio, which includes JBSA-Fort Sam Houston, JBSA-Lackland, and JBSA-Randolph, to Fort Hood in Central Texas. (The Army renamed Fort Cavazos back to Fort Hood in 2025, this time honoring Col. Robert B. Hood, a World War I officer.) Many service members retire near the bases where they served. If you live near Fort Hood, our guide to Medicare plans in Killeen, Temple, and Bell County has the local 2027 plan numbers.

If you're one of them, the year you become eligible for Medicare is a big one. TRICARE For Life depends on Medicare, and the rules leave little room for error.

What TRICARE For Life is

TRICARE For Life (TFL) is what TRICARE calls Medicare-wraparound coverage. It works alongside Original Medicare to lower your out-of-pocket costs. To have it, you need two things:

1. You're eligible for TRICARE, and
2. You have both Medicare Part A and Part B.

Age and where you live don't change that rule. TFL coverage is individual: it doesn't extend to family members. Each person qualifies based on their own Medicare.

Why Part B is not optional for you

For most people, Part B is a choice. For military retirees and their eligible family members, it's the key to keeping TRICARE. TRICARE says you'll lose your TRICARE coverage if you:

• Don't sign up for Part B when you have Part A,
• Drop Part B, or
• Stop paying your Part B premiums.

That's true even if you live overseas.

Part B costs $202.90 a month in 2026 for most people (higher-income enrollees pay more), with a $283 yearly deductible. The 2027 figures are announced each fall. If you get Social Security, your premium is usually deducted from your check. If paying Part B is a struggle, see whether you qualify for help with the Part B premium in Texas.

How enrollment works

When you turn 65, sign up for Parts A and B during your Initial Enrollment Period, which starts 3 months before the month you turn 65 and ends 3 months after it. Our guide on how to sign up for Medicare Parts A and B in Texas walks through the steps.

Once you have both parts, TFL starts automatically on the day both are in place. There's no TFL form to fill out. TRICARE does recommend checking the Defense Enrollment Eligibility Reporting System (DEERS) regularly to make sure your records are right.

If your spouse is still on active duty: Active duty family members with Part A can keep TRICARE without Part B while the sponsor serves. You'll need Part B once your sponsor retires. A Special Enrollment Period runs while the sponsor is on active duty and for 8 months after retirement, but signing up before retirement avoids a break in TRICARE coverage.

If you're under 65 with a disability: Medicare can start before 65 for people on Social Security disability. TRICARE's rules for Part B apply to you too. See Medicare before 65 in Texas.

Who pays first

Situation	Who pays first
Care in the U.S. for Medicare-covered services (not on active duty)	Medicare pays first, then TFL may pay what's left for TRICARE-covered services
Prescriptions, if you join a Medicare Part D plan	Part D pays first, then TRICARE
Care at a military hospital or clinic	Medicare usually doesn't pay for care from federal providers
Care in most overseas locations	TRICARE pays first, since Medicare generally doesn't cover care there

If you have other health insurance, such as coverage through a job, that's billed before TFL.

Drug coverage: Part D is optional

TRICARE pharmacy coverage counts as creditable drug coverage, so you don't need a Medicare Part D plan. TFL beneficiaries stay eligible for the TRICARE Pharmacy Program. If you skip Part B, though, you can generally fill prescriptions only at military pharmacies, one more reason to keep it.

What about Medicare Advantage?

You can join a Medicare Advantage plan and keep TFL, but TRICARE notes that with Medicare Advantage, nonemergency care must come from the plan's provider network. Some retirees weigh that against the flexibility of Original Medicare. Our comparison of Medicare Advantage vs. Original Medicare in Texas can help you think it through.

Free help in Texas

For unbiased Medicare counseling, call the Texas Health Information, Counseling and Advocacy Program (HICAP) at 1-800-252-9240. For TRICARE eligibility questions, check DEERS or contact TRICARE directly. For Medicare questions, call 1-800-MEDICARE.