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Questions

What happens to TRICARE Prime at 65 in North Carolina?

If you're a military retiree or a retiree's family member, TRICARE says you can no longer enroll in TRICARE Prime once you're eligible for premium-free Part A at 65 and have Part B. TRICARE For Life covers you instead, from the first day you have both. Enroll in Part B before your birthday month to avoid a gap.

What changes at 65

Before 65 (TRICARE Prime)At 65 (TRICARE For Life)
Who pays firstTRICAREMedicare, then TRICARE
DoctorsPrimary care manager and TRICARE network, with referralsAny provider who accepts Medicare
Enrollment feePrime enrollment fees for most retireesNo TFL fee; you pay the Part B premium
PrescriptionsTRICARE pharmacyTRICARE pharmacy continues; Part D optional

For many North Carolina retirees that means moving from primary care at Womack Army Medical Center, Naval Medical Center Camp Lejeune or a base clinic to civilian Medicare doctors. TRICARE's handbook says you may keep seeking care at a military hospital or clinic if space is available, and some facilities offer TRICARE Plus, which lets beneficiaries enroll for primary care appointments there.

Your 65th birthday timeline

  1. About 4 months before. If you don't already get Social Security, apply for Medicare Part A and Part B through Social Security (1-800-772-1213 or ssa.gov). If you already get Social Security benefits, you're enrolled automatically.
  2. No later than the month before your birth month. TRICARE says to have Part B in place by then (if your birthday isn't on the first) so TFL starts without a break.
  3. When your Medicare card arrives. Make sure DEERS shows your Medicare coverage, and show both cards to your providers.
  4. Within 90 days of your Medicare start date. Make any TRICARE enrollment changes for family members under 65.
  5. Review drug coverage. TRICARE pharmacy coverage continues; Part D is optional.

If you're eligible for premium-free Part A and don't have Part B, you lose TRICARE coverage except prescriptions at military pharmacies. Signing up late can also add 10% to your Part B premium for each 12-month period you went without it.

Exceptions

  • Active duty family members with Part A can enroll in TRICARE Prime regardless of age if they live in a Prime Service Area, and don't need Part B while the sponsor serves. TRICARE says to sign up for Part B before the sponsor's active duty ends.
  • Still working with employer coverage? You can delay Part B, but TRICARE says to sign up before that coverage ends so TFL starts right away.
  • No premium-free Part A? If neither you nor your spouse qualifies, you don't need Part B to keep TRICARE and can keep TRICARE Prime or Select after updating DEERS with Social Security's notice.

Also a State Health Plan retiree? Retirees turning 65 are moved to the Plan's Medicare options about 90 days before Medicare starts; see State Health Plan retirees and Medicare. More in our guide to military retirees, veterans and TRICARE in North Carolina and turning 65 in North Carolina. If you'd like help with your Medicare choices alongside TFL, you can request a call from a licensed insurance agent.

Sources

More questions in this guide

Part of the guide: Military retirees, veterans and TRICARE in North Carolina: how Medicare fits · All questions

Frequently asked questions

What happens to my spouse's TRICARE Prime when I turn 65?

Nothing changes for a spouse or child under 65. They keep their own TRICARE plan. TRICARE says to request any enrollment changes within 90 days of the Medicare-eligible family member's Medicare effective date.

Can I still be seen at Womack or Camp Lejeune after 65?

TRICARE says you may continue to seek care at a military hospital or clinic if space is available, but you'll likely need civilian Medicare providers. Some facilities offer TRICARE Plus, which gives primary care appointments; ask the facility whether it's available.

What if I'm under 65 with Medicare from a disability?

If you have Part A because of a disability and also have Part B, TRICARE says you don't have to leave TRICARE Prime. If you don't enroll in Prime, you're covered by TFL.

Licensed insurance agents for North Carolina

These independent insurance agents are licensed in North Carolina and work with Benefits Life, the publisher of this site. When they enroll you in a plan, the agent and Benefits Life may be paid by the insurance company. Learn more.

Casey Gilley

Casey Gilley

Accepting new clients

Independent licensed insurance agent in North Carolina

Chapel Hill · English

Steven Graves

Steven Graves

Accepting new clients

Independent licensed insurance agent in North Carolina

Southern Pines · English

Robin Depies

Robin Depies

Accepting new clients

Independent licensed insurance agent in North Carolina

Colorado Springs, CO · English

Jonathan Hernandez Santana

Jonathan Hernandez Santana

Accepting new clients

Independent licensed insurance agent in North Carolina

Haslet, TX · English, Spanish

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