Who must have Part B
TRICARE's TFL handbook (updated August 2026) says that once you're eligible for premium-free Part A, Medicare Part B is required to stay TRICARE-eligible if you are:
- A retired service member, including retired National Guard and Reserve members drawing retired pay
- A family member of a retired service member
- A survivor of a deceased sponsor, or an eligible former spouse
- A Medal of Honor recipient or an eligible family member
That covers most retirees who settle near Fort Bragg, Camp Lejeune, Cherry Point and Seymour Johnson. Medicare.gov adds that most people with TRICARE who are entitled to Part A must also have Part B to keep their TRICARE drug benefits.
When Part B isn't required
| Situation | Part B needed to keep TRICARE? |
|---|---|
| Active duty service member or active duty family member | No, while the sponsor serves. Enroll before active duty ends. |
| Neither you nor your spouse qualifies for premium-free Part A | No. Update DEERS with Social Security's notice. |
| Enrolled in TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult or the Uniformed Services Family Health Plan | Not required, but TRICARE strongly encourages it to avoid late penalties. |
Active duty members and families with end-stage renal disease don't get the Part B Special Enrollment Period. TRICARE says to enroll in Part A and Part B when first eligible.
When to sign up
- Know your Initial Enrollment Period. It's the 7 months around your 65th birthday month. If you already get Social Security, you're enrolled automatically.
- Sign up early in it. If your birthday isn't on the first of the month, TRICARE says to enroll no later than one month before your birth month so TFL starts with no break.
- Working with job-based coverage? TRICARE says you must still have Part B to stay TRICARE-eligible, even with employer coverage, but Medicare lets you delay it while you or your spouse is working and covered. Sign up before that coverage ends so TFL starts right away.
North Carolina retirees sign up for Part B through Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or ssa.gov. If you're a former state employee on the State Health Plan, note the Plan's own rule too: its Medicare Advantage options require Parts A and B. More on Medicare Part B, State Health Plan retirees and our guide to military retirees, veterans and TRICARE in North Carolina. If you have questions about how Part B fits with other coverage, you can request a call from a licensed insurance agent.
Related questions
Does TRICARE For Life work with Medicare?
How the two split the bill.
What happens to TRICARE Prime at 65?
Your birthday timeline.
Can retirees use the Fort Bragg pharmacy?
What happens without Part B.
Sources
- TRICARE — TRICARE For Life Handbook (updated August 2026)
- TRICARE — Becoming Medicare-eligible
- Medicare.gov — Who pays first? (TRICARE)
- Social Security — Sign up for Medicare
More questions in this guide
- Can military retirees on Medicare use the Fort Bragg pharmacy?
- Can veterans have Medicare Advantage and VA care in North Carolina?
- Do I need Medicare if I have VA health care in North Carolina?
- Does Medicare cover illnesses from Camp Lejeune water contamination?
- Does TRICARE For Life work with Medicare in North Carolina?
- What happens to TRICARE Prime at 65 in North Carolina?
Part of the guide: Military retirees, veterans and TRICARE in North Carolina: how Medicare fits · All questions
Frequently asked questions
I'm still on active duty at 65. Do I need Part B?
No. Active duty service members and their families can delay Part B and sign up in a Special Enrollment Period while on active duty or within 8 months after the sponsor retires or TRICARE ends, whichever comes first. TRICARE says to sign up before active duty ends to avoid a gap.
What if I don't qualify for premium-free Part A?
If neither you nor your spouse qualifies for premium-free Part A, you don't need Part B to keep TRICARE. Take Social Security's notice to a Uniformed Services ID card office so DEERS is updated.
I have Medicare because of a disability. Do I need Part B?
Yes, if you're a retiree or a retiree's family member. TRICARE says this applies whether you have Medicare because of age, a disability or end-stage renal disease.
What does Part B cost?
The standard Part B premium is $202.90 a month in 2026; people with higher incomes pay more. Signing up late adds 10% for each full 12-month period you could have had it.
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