Yes. Military retirees do have to pay for Medicare Part B once they become eligible for Medicare at age 65, and for most people the 2026 premium is $202.90 per month.1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles Paying that premium isn’t optional if you want to keep your military health benefits. Without Part B, you lose TRICARE entirely, including the pharmacy benefit.2TRICARE. Retired Service Members and Families
Why Part B Is Tied to Your TRICARE Coverage
At 65, Medicare becomes your primary health coverage and TRICARE moves into a secondary role through TRICARE For Life (TFL). To keep any TRICARE coverage at that point, you must have both Medicare Part A and Part B.2TRICARE. Retired Service Members and Families Part A is premium-free for most retirees because of the payroll taxes paid during a working career. Part B is the piece you have to pay for every month.
Once you have both parts, you’re automatically covered by TFL. There’s no separate application and no additional premium beyond what you pay Medicare for Part B.
A few narrow groups are exempt from the Part B requirement: family members of active-duty service members, people enrolled in the Uniformed Services Family Health Plan, and those in TRICARE Reserve Select or TRICARE Retired Reserve.3TRICARE Manuals. TRICARE For Life (TFL) and Other Medicare-Eligible Beneficiaries For the vast majority of retirees and their Medicare-eligible dependents, though, the requirement is absolute.
What You’ll Pay in 2026
The standard 2026 Part B premium is $202.90 per month.1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles Most retirees pay this amount. Higher-income retirees pay more through the Income-Related Monthly Adjustment Amount, or IRMAA.
IRMAA Brackets for 2026
The Social Security Administration looks at the modified adjusted gross income on your federal tax return from two years earlier. Your 2026 premium is based on your 2024 return.1Centers for Medicare & Medicaid Services. 2026 Medicare Parts A & B Premiums and Deductibles Total monthly premiums for 2026:
- Up to $109,000 single or $218,000 joint: $202.90
- $109,001–$137,000 single or $218,001–$274,000 joint: $284.10
- $137,001–$171,000 single or $274,001–$342,000 joint: $405.80
- $171,001–$205,000 single or $342,001–$410,000 joint: $527.50
- $205,001–$499,999 single or $410,001–$749,999 joint: $649.20
- $500,000+ single or $750,000+ joint: $689.90
Military retirement pay, VA disability compensation, Social Security benefits, and investment income all feed into that modified adjusted gross income figure. Retirees drawing from several sources sometimes land in a higher bracket than they expect.
Asking for a Lower Premium After a Life Change
If your income has fallen since the tax year SSA is using, you can ask for a reduction. Qualifying life-changing events include retirement from a civilian job, the death of a spouse, divorce, or the loss of other income. File Form SSA-44 online through your Social Security account, by fax, or by mail.4Social Security Administration. Request to Lower an Income-Related Monthly Adjustment Amount This matters for retirees who worked a second civilian career and stopped that job right around 65; the two-year-old return SSA is looking at may reflect an income they no longer have.
How the Premium Is Paid
If you receive Social Security or Railroad Retirement Board benefits, your Part B premium is deducted automatically from those payments. If you’re not yet collecting Social Security, Medicare bills you directly. You can pay online through your Medicare account, set up automatic bank withdrawals through Medicare Easy Pay, use your bank’s bill-pay service, or mail a check.5Medicare. How to Pay Part A & Part B Premiums
What Happens If You Don’t Enroll or Stop Paying
Two things happen, and both are lasting.
First, you lose all TRICARE coverage. Not just TFL. All of it, including pharmacy.2TRICARE. Retired Service Members and Families Your only remaining option for military healthcare would be space-available care at military treatment facilities, which is limited and unreliable. If you later enroll in Part B, TRICARE eligibility comes back on the date your Part B coverage takes effect, but there’s no way to restore coverage retroactively for the months you were without it.3TRICARE Manuals. TRICARE For Life (TFL) and Other Medicare-Eligible Beneficiaries
Second, Medicare imposes a permanent late-enrollment penalty. For every full 12-month period you were eligible for Part B but didn’t enroll, your premium goes up by 10%. A two-year gap means a 20% surcharge added to whatever the standard premium is when you finally sign up. On the 2026 standard premium of $202.90, a 20% penalty adds roughly $40.58 per month.6Medicare. Avoid Late Enrollment Penalties That surcharge never goes away. You pay it for as long as you have Part B.
When to Enroll
Your first chance to sign up is the Initial Enrollment Period, a seven-month window beginning three months before the month you turn 65 and ending three months after. Sign up in the first three months and coverage starts the month you turn 65; sign up during your birth month or later and coverage starts the following month.7Medicare. When Does Medicare Coverage Start To avoid any gap between your pre-65 TRICARE plan and TFL, enroll in the first three months of the window.
Enrollment goes through the Social Security Administration, not TRICARE or DoD. The fastest route is ssa.gov, or you can call 1-800-772-1213 or visit a local Social Security office.8Social Security Administration. When to Sign Up for Medicare
If You’re Still Working at 65
If you have health insurance through a current civilian job at 65, you can delay Part B without triggering the Medicare late penalty. When the job or the employer coverage ends, you get an eight-month Special Enrollment Period to sign up.
Two catches trip retirees up. COBRA and retiree health plans don’t count as current employer coverage; if you leave a job and go on COBRA thinking you can delay Part B, months will start counting toward the late penalty. And even though Medicare permits the delay, TRICARE does not waive its Part B requirement. During any period you lack Part B, you have no TRICARE, and TFL won’t act as a secondary payer to your employer plan.2TRICARE. Retired Service Members and Families For most military retirees, the safer move is to enroll in Part B on time regardless of employer coverage.
Living Overseas Doesn’t Change the Rule
Military retirees living outside the United States still have to enroll in and pay for Part B to keep TRICARE, even though Medicare won’t pay for care received overseas.9TRICARE. Using TRICARE For Life Overseas It can feel like paying for something you can’t use. But dropping Part B ends TRICARE too, which would leave you with no U.S.-backed coverage at all abroad. When you receive care overseas, TRICARE pays as the primary payer, and you’re responsible for its annual deductible and cost-shares.
Help If You Can’t Afford the Premium
Retirees with limited income may qualify for a Medicare Savings Program that pays some or all Part B costs. These are state-administered programs with federal income and resource guidelines. For 2026, monthly income limits run from $1,350 to $1,816 for individuals and $1,824 to $2,455 for married couples, depending on the program. Resource limits are $9,950 for individuals and $14,910 for couples.10Medicare. Medicare Savings Programs
The Qualified Medicare Beneficiary program covers the Part B premium along with deductibles and coinsurance. Two other programs, SLMB and QI, cover only the premium but have higher income limits. Many states set thresholds above the federal minimums, so it’s worth applying through your state Medicaid office even if you think you’re over the limit.