What changes at 65
| Before 65 (TRICARE Prime) | At 65 (TRICARE For Life) | |
|---|---|---|
| Who pays first | TRICARE | Medicare, then TRICARE |
| Doctors | Primary care manager and TRICARE network, with referrals | Any provider who accepts Medicare |
| Enrollment fee | Prime enrollment fees for most retirees | No TFL fee; you pay the Part B premium |
| Prescriptions | TRICARE pharmacy | TRICARE 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
- 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.
- 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.
- When your Medicare card arrives. Make sure DEERS shows your Medicare coverage, and show both cards to your providers.
- Within 90 days of your Medicare start date. Make any TRICARE enrollment changes for family members under 65.
- 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.
Related questions
Do I need Part B with TRICARE For Life?
Who must keep it.
Does TRICARE For Life work with Medicare?
Who pays first.
Can retirees use the Fort Bragg pharmacy?
Prescriptions after 65.
Sources
- TRICARE — Becoming Medicare-eligible
- TRICARE — TRICARE For Life Handbook (updated August 2026)
- TRICARE — TRICARE For Life
- State Health Plan for Teachers and State Employees
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?
- 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?
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.
Medicare in your North Carolina county
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