Quick answers
- Do I need Part B to keep TRICARE at 65?
- Yes, if you're eligible for premium-free Part A and you're a retiree, a retiree's family member, a survivor or an eligible former spouse. Without Part B you can only fill prescriptions at military pharmacies.
- What happens to TRICARE Prime at 65?
- For retirees and their families, TRICARE says you're no longer eligible to enroll in TRICARE Prime once you're 65 with Part A and Part B, unless you have an active duty sponsor. TFL covers you instead.
- Does Medicare pay for care at a VA medical center?
- No. VA providers can't bill Medicare, and Medicare and VA can't pay for the same service. Each time you get care, you choose which benefit to use.
- Do I need Part D with TRICARE For Life or VA care?
- Usually not. Part D is optional. Medicare's drug coverage guide says that if you later lose TRICARE or VA coverage and need a Medicare drug plan, in most cases you won't owe a late penalty.
- Who covers Camp Lejeune water illnesses?
- VA. Eligible veterans pay no VA copay for care of 15 covered conditions, and VA's Family Member Program reimburses eligible family members after Medicare and other insurance pay.
Who this guide is for
North Carolina is home to Fort Bragg (the Army restored the name in 2025, now honoring Pfc. Roland L. Bragg, a World War II soldier), Marine Corps Base Camp Lejeune and Marine Corps Air Station New River in Onslow County, Marine Corps Air Station Cherry Point in Havelock and Seymour Johnson Air Force Base in Goldsboro. Many service members retire near these bases. This page covers how Medicare works with:
- TRICARE For Life (TFL): military retirees, their family members, survivors and eligible former spouses who have Medicare.
- VA health care: veterans enrolled with the U.S. Department of Veterans Affairs.
- CHAMPVA: certain spouses, survivors and dependents of veterans.
- Camp Lejeune benefits: veterans and family members exposed to the base's contaminated water from 1953 to 1987.
Still working with job-based coverage? See working past 65. Retired from a North Carolina state job? See State Health Plan retirees and Medicare.
How TRICARE For Life works with Medicare
TRICARE calls TFL "Medicare-wraparound coverage." It's automatic once you have Medicare Part A and Part B; you don't enroll in it or pay a TFL fee. You do pay the Part B premium ($202.90 a month for most people in 2026).
| Your situation | Pays first | Pays next |
|---|---|---|
| Retired, with Medicare and TFL only | Medicare | TRICARE (TFL) |
| You or your spouse still work and have employer coverage | Employer plan | Medicare, then TRICARE |
| A service only TRICARE covers (for example, care overseas) | TRICARE | You pay TRICARE's deductible and cost shares |
| Care at a military hospital or clinic | TRICARE | (Medicare doesn't pay) |
With Original Medicare, the provider bills Medicare, and Medicare sends the claim on to TRICARE's TFL claims processor. TFL covers the Part B deductible for services both programs cover, and TRICARE covers the up-to-15% excess charge a non-participating Medicare provider may bill. Check what a Medigap policy would add before you buy one.
You can also join a Medicare Advantage plan and keep TFL. TRICARE's TFL handbook says you must use the plan's network except for emergencies, and that TFL can reimburse copayments you paid for TRICARE-covered services when you file a paper claim. Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
For 2027, CMS lists 40 Medicare Advantage plans open to everyone in Cumberland County (Fort Bragg), 14 in Onslow County (Camp Lejeune), 13 in Craven County (Cherry Point) and 22 in Wayne County (Seymour Johnson). See your county page.
Why you need Part B
TRICARE's TFL handbook (updated August 2026) says that once you're eligible for premium-free Part A, Part B is required to stay TRICARE-eligible if you're a retired service member (including retired National Guard and Reserve members drawing retired pay), a retiree's family member, a survivor, an eligible former spouse or a Medal of Honor recipient. This applies whether you have Medicare because of age, a disability or end-stage renal disease. Without Part B, TRICARE says you can only fill prescriptions at military pharmacies.
- Active duty exception: active duty service members and their families don't need Part B while the sponsor serves. They get a Part B Special Enrollment Period while on active duty or within 8 months after the sponsor retires or TRICARE coverage ends, whichever comes first, and TRICARE says to sign up before active duty ends to avoid a break. Those with ESRD don't get that Special Enrollment Period.
- No premium-free Part A: if neither you nor your spouse qualifies, 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.
- Late penalty: signing up after your Initial Enrollment Period can add 10% to your premium for each 12-month period you could have had Part B, for as long as you have it.
More on Medicare Part B, enrollment periods and turning 65 in North Carolina.
Turning 65: what happens to TRICARE Prime
TRICARE says that once you're eligible for premium-free Part A at 65 and have Part B, you're eligible for TFL and no longer eligible to enroll in TRICARE Prime, unless you have an active duty sponsor. You may still use a military hospital or clinic if space is available, but TRICARE says you'll likely need civilian Medicare providers.
- Sign up for Part B on time. If your birthday isn't on the first of the month, TRICARE says to enroll no later than one month before your birth month to avoid a break in coverage.
- Check DEERS. TRICARE uses it to confirm your Medicare status.
- Family members under 65 keep their own TRICARE plan. TRICARE says to request any enrollment changes within 90 days of the Medicare-eligible family member's Medicare start date.
- Review drug coverage. TRICARE pharmacy coverage continues; Part D is optional.
If you have Medicare before 65 because of a disability and also have Part B, you can stay in TRICARE Prime if you qualify. More in what happens to TRICARE Prime at 65.
Prescriptions: military pharmacies, home delivery and Part D
TFL beneficiaries can fill prescriptions at military pharmacies, through TRICARE Pharmacy Home Delivery, or at retail pharmacies. TRICARE's handbook says that at a military pharmacy you can get up to a 90-day supply of most medications at no cost, that most military pharmacies accept prescriptions from civilian and military providers whether or not you're enrolled at that hospital or clinic, and that non-formulary drugs generally aren't available there.
In North Carolina, CMS's hospital data lists two military hospitals: Womack Army Medical Center at Fort Bragg and Naval Medical Center Camp Lejeune. TRICARE's facility listing says Womack accepts electronic prescriptions from civilian providers. Military clinics include the 4th Medical Group at Seymour Johnson and Naval Health Clinic Cherry Point. Hours and which drugs are stocked change, so check the facility before you transfer a prescription. See can military retirees use the Fort Bragg pharmacy?
Weight-loss drugs: TRICARE says that since August 31, 2025, its pharmacy benefit doesn't cover weight-loss drugs for TFL beneficiaries, and that since July 1, 2026, Medicare Part D covers certain weight-loss drugs under the Medicare GLP-1 Bridge Program. If you need one, compare Part D coverage. See Part D in North Carolina.
Medicare's drug coverage guide says that for most people with TRICARE, CHAMPVA or VA coverage, unless they qualify for Extra Help, it isn't cost-effective to get Medicare drug coverage. If you have both, your Part D plan pays first and TRICARE pays second.
VA health care and Medicare
Medicare.gov says that if you have both Medicare and VA benefits, you can get treatment under either program, but Medicare and VA can't pay for the same items or services. VA pays for VA-authorized care in a VA or non-VA facility. If VA authorizes a non-VA hospital stay but not every service during it, Medicare may pay for the Medicare-covered services VA didn't authorize.
- VA encourages signing up for Medicare at 65. VA says Medicare covers you at non-VA hospitals and doctors, VA funding could change, and veterans in lower priority groups could lose VA care in the future. Delaying Part B can mean a late penalty.
- VA drug coverage is creditable, so you can delay Part D without a penalty if you join within 63 days of losing it. If you join a Part D plan, you can't use both for the same prescription.
- Veterans with both TFL and VA: TRICARE says VA providers can't bill Medicare, and by law TRICARE pays only up to 20% of its allowable amount for VA care not related to your service, so you could owe up to 80% of the bill. Medicare providers are usually your less expensive choice for that care.
More in do I need Medicare if I have VA care? and can veterans have Medicare Advantage and VA care?
VA medical centers in North Carolina
| VA medical center | City |
|---|---|
| Charles George VA Medical Center | Asheville |
| Durham VA Medical Center | Durham |
| Fayetteville VA Medical Center (Fayetteville VA Coastal Health Care System) | Fayetteville |
| W.G. (Bill) Hefner VA Medical Center | Salisbury |
VA also runs outpatient clinics across the state; find the nearest at va.gov/find-locations.
Camp Lejeune water contamination
VA says veterans who served at Camp Lejeune or MCAS New River for at least 30 days total between August 1, 1953, and December 31, 1987, may enroll in VA health care and pay no VA copay for care of 15 covered conditions, among them bladder, breast, esophageal, kidney and lung cancer, leukemia, multiple myeloma, non-Hodgkin's lymphoma and renal toxicity. Family members who lived there in that period can apply to VA's Camp Lejeune Family Member Program, which VA says is always the last payer: Medicare and other insurance pay first. Full details in does Medicare cover Camp Lejeune illnesses?
CHAMPVA
VA says that if you're eligible for Medicare, you must have Medicare Part A and Part B to get or keep CHAMPVA, and that people eligible for or enrolled in TRICARE can't get CHAMPVA. If you're 65 or older and don't qualify for Medicare, you send VA Social Security's notice of disallowance.
If you're also a State Health Plan retiree
Many North Carolina military retirees later retire from state or public school jobs. The State Health Plan says TFL members may enroll in its group Medicare Advantage plans (the Base Plan or Enhanced Plan) and that TFL typically covers copays and coinsurance. The Plan also warns that joining an outside Medicare Advantage or Part D plan disenrolls you from its group Medicare Advantage plan and moves you to the 70/30 Plan. See State Health Plan retirees and Medicare.
Where North Carolina veterans can get help
- N.C. Department of Military & Veterans Affairs: benefits specialists in 12 Veterans Service Centers help with VA claims (milvets.nc.gov).
- TRICARE and TFL: tricare.mil/tfl. DEERS: 800-538-9552.
- Medicare: 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). Social Security (Part B sign-up): 1-800-772-1213 (TTY 1-800-325-0778).
If you're weighing Medicare Advantage or Part D alongside TFL or VA care, you can request a call from a licensed insurance agent, or meet licensed insurance agents in North Carolina.
Sources
- TRICARE — TRICARE For Life
- TRICARE — Becoming Medicare-eligible
- TRICARE — TRICARE For Life Handbook (updated August 2026)
- TRICARE — If I have Medicare and TRICARE, do I need Medicare Part D?
- TRICARE — Womack Army Medical Center facility listing
- Medicare.gov — Who pays first? (Veterans' benefits; TRICARE)
- CMS — Your Guide to Medicare Drug Coverage (Product No. 11109, June 2026)
- U.S. Department of Veterans Affairs — VA health care and other insurance
- U.S. Department of Veterans Affairs — CHAMPVA benefits
- U.S. Department of Veterans Affairs — Camp Lejeune water contamination health issues
- U.S. Department of Veterans Affairs — Camp Lejeune Family Member Program
- CMS — Hospital General Information (military and VA hospitals in North Carolina)
- U.S. Army — Back to Bragg: Fort Bragg redesignation ceremony
- State Health Plan for Teachers and State Employees — Medicare-primary retiree options
- N.C. Department of Military & Veterans Affairs
Every question 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?
- Do I need Medicare Part B with TRICARE For Life?
- 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?
Frequently asked questions
Does VA drug coverage count as creditable coverage for Part D?
Yes. Medicare's drug coverage guide names VA and TRICARE among the kinds of creditable drug coverage, and VA says there's no Part D penalty as long as you join within 63 days of losing VA or other creditable coverage.
Can I have CHAMPVA and Medicare?
Yes, but VA says that if you're eligible for Medicare, you must have Medicare Part A and Part B to get or keep CHAMPVA. People eligible for TRICARE can't get CHAMPVA.
Where are the VA medical centers in North Carolina?
VA runs four medical centers in North Carolina: the Charles George VA Medical Center in Asheville, the Durham VA Medical Center, the Fayetteville VA Medical Center and the W.G. (Bill) Hefner VA Medical Center in Salisbury, plus clinics across the state.
Can Medicare-age military retirees get care at Camp Lejeune, Cherry Point or Seymour Johnson?
TRICARE says TFL beneficiaries can use military hospitals and clinics only if space is available, and will likely need civilian Medicare providers. Military pharmacies are a separate question: most fill prescriptions for TFL beneficiaries, but check the facility first.
Do I need Part D if I have TRICARE For Life?
No. TRICARE says TFL includes drug coverage through the TRICARE Pharmacy Program, so you don't need Part D. If you join a Part D plan anyway, the Part D plan pays first and TRICARE pays second.
Can I keep TFL if I'm on the State Health Plan as a retiree?
Yes. The State Health Plan says TRICARE For Life members may enroll in its group Medicare Advantage plans and that TFL typically covers copays and coinsurance. Joining an outside Medicare Advantage or Part D plan would move you to the 70/30 Plan.
Medicare in your North Carolina county
Plans, local agents and help, county by county: Wake · Mecklenburg · Guilford · Forsyth · Durham · Cumberland · Buncombe · Union · Johnston · Cabarrus · New Hanover · Gaston · Onslow · Iredell · Alamance · Pitt · Davidson · Brunswick · Catawba · Rowan · All 100 counties →
