Dependents and Tricare for Life: What Families Need to Know
When a military retiree turns 65 and moves into Tricare for Life (TFL) with Medicare Parts A & B, the rest of the family often wonders: “What happens to us?” Spouses and children don’t automatically move into TFL just because the retiree does. Instead, dependents each follow their own eligibility rules. This guide walks through what happens step by step.
When the Retiree Moves Into TFL
Retiree at 65: Must enroll in Medicare Part A and Part B. Once active, coverage automatically becomes Tricare for Life. Medicare pays first, TFL pays second.
Spouse under 65: Remains on Tricare Prime or Select until their own 65th birthday. At that time, they must also enroll in Medicare Parts A & B to shift into TFL.
Children: Remain covered under Tricare Prime or Select as long as they are age-eligible.
📎 TRICARE FAQ – Spouse Younger than Sponsor at 65
Age-Out Rules for Children
Children don’t move into TFL just because the retiree does. Instead, they age out of standard Tricare coverage:
Standard Rule: Coverage until age 21.
If in College: Coverage until age 23, provided they are enrolled full-time and the retiree provides at least 50% support.
After Age-Out: Regular Tricare Prime/Select coverage ends.
📎 Tricare – Eligibility for Children
What Happens Next: Tricare Young Adult (TYA)
After age-out, children may purchase Tricare Young Adult (TYA), which extends coverage until age 26.
Eligibility: Unmarried, under 26, not eligible for employer-sponsored insurance.
Plan Options:
TYA Prime – Like Tricare Prime (where available).
TYA Select – Like Tricare Select, available worldwide.
Costs: Monthly premiums paid by the young adult, plus standard cost-shares.
Special Circumstances: When Dependents Qualify for Medicare
While most children and spouses don’t enter TFL until they turn 65, there are exceptions:
Disability: After 24 months of SSDI, dependents may qualify for Medicare.
End-Stage Renal Disease (ESRD): Medicare eligibility at any age with permanent kidney failure.
ALS (Lou Gehrig’s disease): Medicare eligibility begins the same month SSDI starts.
In these cases:
The dependent must enroll in Medicare Part A and Part B.
Their Tricare coverage will shift to TFL, regardless of age.
Premiums and Costs to Expect
Children on Tricare Prime or Select
They remain covered under the family’s single or family-rate premium, depending on whether both spouse + children are enrolled.
The retiree’s shift to TFL does not remove the need to pay these premiums for younger children.
Children on Tricare Young Adult (TYA)
Once a child ages out (21, or 23 if a student), they may buy TYA.
TYA has its own monthly premium, separate from family coverage.
Costs are set annually and depend on whether the child enrolls in TYA Prime or TYA Select.
Children Who Qualify for Medicare (Special Cases)
If a child becomes Medicare-eligible due to disability, ESRD, or ALS, they must enroll in Medicare Parts A & B.
At that point, they transition to TFL, and their main cost becomes the Medicare Part B premium.
Key Takeaways
TFL is individual-based. Spouses and children don’t move into TFL until they become Medicare-eligible themselves.
Children age out of regular Tricare at 21 (or 23 in college).
TYA extends coverage until age 26 for those who qualify.
Special circumstances (disability, ESRD, ALS) can make dependents Medicare-eligible earlier, in which case they shift to TFL.
Families should plan ahead for both age-based transitions and special medical situations to avoid gaps in coverage.
Bottom Line: When the retiree moves into Tricare for Life, dependents don’t automatically follow. Spouses stay on Prime/Select until their own 65th birthday, children remain covered until they age out, and then TYA may bridge coverage until 26. In rare cases, dependents with disabilities or certain health conditions may qualify for Medicare early, which allows them to move into TFL.