Medigap and TRICARE For Life: Do You Need Both?

If you are a military retiree with TRICARE For Life (TFL) and you are approaching Medicare eligibility, you might be wondering if you also need to buy a Medicare Supplement (Medigap) plan. The short answer is: probably not.

For the vast majority of military retirees, TRICARE For Life acts as your Medicare Supplement. When you have both Medicare Parts A and B and TRICARE For Life, Medicare pays its share of your medical bills first, and then TFL pays the remaining out-of-pocket costs for Medicare-covered services. Because TFL covers almost everything that a Medigap plan would cover - and often does it with no monthly premium beyond your Part B premium - buying a Medigap policy is usually an unnecessary expense.

How Medicare and TRICARE For Life Work Together

To keep your TRICARE For Life coverage, you must enroll in Medicare Part A and Part B when you become eligible. Once you are enrolled in both, TFL coverage is automatic. You do not need to fill out an enrollment form or pay a separate premium for TFL.

When you visit a doctor or hospital that accepts Medicare, the provider will bill Medicare first. Medicare pays its approved amount, and then automatically forwards the claim to TRICARE. TRICARE then pays the remaining amount (the deductibles, coinsurance, and copayments) directly to the provider. In most cases, you will have zero out-of-pocket costs for services covered by both Medicare and TRICARE.

Why You Don't Need a Medigap Plan

A Medigap plan is designed to fill the "gaps" in Original Medicare - the 20% coinsurance, the deductibles, and the copayments. But if you have TRICARE For Life, TFL is already filling those gaps.

If you were to buy a Medigap plan, you would be paying a monthly premium for coverage you already have. Furthermore, by law, it is illegal for an insurance company to sell you a Medigap policy if they know you have TRICARE For Life, unless you are dropping TFL.

The Medicare Module: Two Paths

When you become eligible for Medicare, you face a choice between two paths: Traditional Medicare (Parts A and B) or Medicare Advantage (Part C).

If you choose Traditional Medicare, TRICARE For Life works seamlessly as your secondary payer. You can see any doctor or hospital in the country that accepts Medicare, and TFL will pick up the remaining costs.

If you choose a Medicare Advantage plan, you are opting for a private insurance plan that replaces your Traditional Medicare. While you can have both Medicare Advantage and TFL, it often complicates your billing and restricts you to the Advantage plan's network of doctors. For most TFL beneficiaries, sticking with Traditional Medicare and letting TFL act as your supplement is the most straightforward and cost-effective path.

When Might You Need a Medigap Plan?

There are very few scenarios where a military retiree with TFL would need a Medigap plan. The most common exception is if you live overseas. Medicare generally does not cover healthcare outside the United States, but TRICARE Standard Overseas does. However, if you frequently travel abroad and want additional coverage, some Medigap plans (like Plan G or Plan N) offer foreign travel emergency coverage. But even then, you must weigh the cost of the Medigap premium against the benefits provided by TRICARE Overseas.

You earned your TRICARE benefits through years of service, and you shouldn't pay for insurance you don't need. If you have questions about how your TRICARE For Life works with Medicare, or if you want to make sure you are set up correctly, we can help. We'll walk you through every option and make sure you have the right coverage in place. Compare free, no obligation.