In short: In Guatemala, Medicare pays nothing, so TRICARE becomes the primary payer for a military retiree, whether you live here or are visiting. TRICARE For Life (TFL) covers you worldwide, but TRICARE says that if you live overseas you must keep Medicare Part B ($202.90 a month in 2026) to stay TRICARE-eligible. Abroad you pay TRICARE’s deductible ($150 per person, $300 per family, 2026) and cost-shares, up to a $3,000 family cap. For retirees not yet on Medicare, the plan tricare.mil points to is TRICARE Select Overseas, which needs enrolment and, for Group A and B retirees, an annual fee. Either way, International SOS says to expect to pay up front and claim back; Guatemala has no TRICARE toll-free line. All read on tricare.mil and tricare-overseas.com on 2 October 2026.
This page is for US military retirees and their families with TRICARE. If you are a veteran with a VA service-connected rating, the VA’s own programme is on the VA Foreign Medical Program page. For everyone else’s options, see health insurance for expats in Guatemala.
The decision table
| Your situation | Plan TRICARE describes | What it costs you in 2026 | Source |
|---|---|---|---|
| TRICARE-eligible, with Medicare Part A and Part B (any age) | TRICARE For Life: automatic, worldwide | No TRICARE fee; Part B premium; TRICARE deductible $150/$300 and cost-shares abroad; $3,000 family cap | tricare.mil, TFL and cost pages |
| Retiree without Medicare Part A and B, Group A (service began before 1 Jan 2018) | TRICARE Select Overseas: enrolment required | Enrolment $186.96 individual / $375 family a year; deductible $150/$300; cap $4,381 per family | tricare.mil, 2026 cost table |
| Retiree without Medicare Part A and B, Group B (service began on or after 1 Jan 2018) | TRICARE Select Overseas: enrolment required | Enrolment $594.96 individual / $1,191 family a year; deductible $198 network or $397 non-network per person; cap $4,635 per family | tricare.mil, 2026 cost table |
| Sponsor on active duty | TRICARE Prime Overseas or Prime Remote Overseas may apply | Not covered on this page | tricare.mil, TRICARE Select Overseas page |
TRICARE sorts your costs by your sponsor’s group: Group A if the sponsor’s first enlistment or appointment began before 1 January 2018, Group B if it began on or after that date.
TRICARE For Life in Guatemala
TRICARE’s own definition: “TRICARE For Life is Medicare-wraparound coverage if you’re TRICARE-eligible and have Medicare Part A and Part B, regardless of age or place of residence.” There is no card and no enrolment form: International SOS says “There is no enrollment form and no annual fee for TFL.” You are covered automatically if you are entitled to Part A, have Part B, and your contact details in DEERS are up to date. TFL covers the beneficiary, not the household: tricare.mil says “Coverage doesn’t extend to family members.”
In the US, Medicare pays first and TRICARE pays what’s left. Guatemala flips that order. tricare.mil:
“When using TRICARE For Life in all other overseas locations, whether you live overseas or are traveling overseas, TRICARE is the primary payer and you’re responsible for paying TRICARE’s annual deductible and cost-shares.”
The 2026 TFL figures on tricare.mil’s cost page: no TRICARE premium, a TRICARE deductible of $150 per individual or $300 per family a year, which, in tricare.mil’s words, “You must pay the TRICARE deductible when TRICARE is the only payer.”, and a TRICARE catastrophic cap of $3,000 per family a year.
The Part B rule
tricare.mil:
“Important: If you live overseas, you must have Medicare Part B to remain eligible for TRICARE even though Medicare doesn’t provide coverage overseas.”
International SOS states the condition: if the sponsor is retired and you are entitled to premium-free Part A on your own or your spouse’s record, you must have Part B to remain TRICARE-eligible. Medicare.gov lists the 2026 standard Part B premium at $202.90 a month. So a TFL retiree in Guatemala pays a Medicare premium for coverage Medicare itself doesn’t provide here, because that premium is what keeps the TRICARE coverage that does. For the Medicare side of that decision (late-enrolment penalties, when coverage restarts), see the healthcare transition guide.
TRICARE Select Overseas for retirees not on Medicare
If you are not yet on Medicare, the plan tricare.mil points to is TRICARE Select Overseas: “TRICARE Select Overseas may be your only option when you live overseas. You can also purchase other health insurance.” It covers retired service members and their families, survivors and qualified former spouses, among others, and enrolment is required.
How to enrol. International SOS lists two routes: TRICARE’s Beneficiary Web Enrollment, or DD Form 3043 sent to International SOS by email (TRICAREenrollments@top.internationalsos.com), fax (+1-215-773-2740) or post (International SOS Government Services, LLC, TRICARE Select Overseas Enrollments, PO Box 760217, San Antonio, TX 78245).
How the fee is paid. International SOS says Group A retirees must pay a monthly enrolment fee to keep TRICARE Select, as they have since 1 January 2021. It is taken as an allotment from retired pay where feasible; otherwise by recurring credit or debit card, or by electronic funds transfer, and “Your EFT must be from a U.S. bank.” A Guatemalan bank account can’t be the source of an EFT payment under that rule.
What it costs. The 2026 amounts for retirees are in the decision table above. On top of the deductible you pay cost-shares, which tricare.mil sets per type of service on its cost page.
Paying a Guatemalan hospital, and getting it back
International SOS says the same thing for both plans: “You should expect to pay up front for care and submit a claim to the TOP Claims processor for reimbursement.” (TOP is the TRICARE Overseas Program.) Two more rules from the same pages:
- You can see any overseas civilian provider without a referral, but some services need prior authorization, including non-emergency inpatient admissions for substance use disorders and mental health care.
- Non-network providers set their own prices. “Note: Outside the U.S. and U.S. territories, nonparticipating non-network providers can charge any amount for care. You’re responsible for paying any amount that is above the TRICARE-allowable charge in addition to your deductible and cost-shares.” The reimbursement is capped at what TRICARE allows, so the gap above that is yours.
Filing the claim. International SOS’s steps:
- Complete DD Form 2642 (Patient’s Request for Medical Payment), all 12 blocks, and sign it.
- Attach a readable copy of the provider’s bill, showing the sponsor’s SSN or DoD Benefits Number, the provider’s name and address, the date and place of each service, a description and charge for each, and the diagnosis.
- Add a short narrative of why you needed the care, and proof of payment. If you paid a provider $10,000 or more, add the Proof of Payment Attestation Form. If you have other health insurance, include its explanation of benefits: “TRICARE is always the last payer.”
- Submit online through the TOP Beneficiary Secure Claims Portal, or mail it to the address for the area where you received care. For Guatemala, the address International SOS lists for all beneficiaries except active duty is TRICARE Overseas Program, PO Box 7985, Madison, WI 53707-7985, USA.
International SOS’s home page also lists a medical records translation service for TRICARE Overseas beneficiaries.
The Guatemala contact sheet
From International SOS’s Guatemala page (read 2 October 2026):
| Line | Number or address |
|---|---|
| Customer service, regional direct | +1-215-942-8393 |
| Customer service, toll free | Not available |
| Medical assistance, regional direct | +1-215-942-8320 |
| Medical assistance, toll free | Not available |
| Assistance centre fax | +1-215-773-2701 |
| Claims (all except active duty) | TRICARE Overseas Program, PO Box 7985, Madison, WI 53707-7985, USA |
| Select Overseas enrolment | International SOS Government Services, LLC, PO Box 760217, San Antonio, TX 78245, USA |
| Enrolment email | TRICAREenrollments@top.internationalsos.com |
International SOS also notes that toll-free lines may not be available for all mobile carriers overseas.
If you are a veteran as well
TRICARE and the VA’s Foreign Medical Program are separate. If you also have a VA service-connected rating, FMP may pay for care of that rated condition; see VA Foreign Medical Program in Guatemala. For everything else, TRICARE’s rules above apply.
Related pages
- VA Foreign Medical Program in Guatemala
- Health insurance for expats in Guatemala
- Medicare on a trip to Guatemala
- Healthcare transition for returnees: Medicare Part B, IGSS and private care
- Healthcare for retirees in Guatemala
- Hospitals in Guatemala City
- Moving from the USA hub
Sources
All read 2 October 2026.
- tricare.mil: TRICARE For Life — definition, worldwide coverage, overseas primary payer, Part B rule (last updated 25 September 2026)
- tricare.mil: Using TRICARE For Life Overseas
- tricare.mil: TRICARE Select Overseas — who can enrol, pay up front and claim (last updated 13 March 2026)
- tricare.mil: Health plan costs — 2026 amounts for retirees (Group A, Group B) and TRICARE For Life
- International SOS (TRICARE Overseas Program): TRICARE For Life
- International SOS: TRICARE Select Overseas for Retirees — enrolment, fee payment
- International SOS: How to file a TRICARE Overseas claim
- International SOS: Guatemala contact information
- Medicare.gov: Medicare costs — 2026 Part B premium
This page describes TRICARE’s and International SOS’s published rules. It is not advice on your coverage; TRICARE and its contractor decide each claim.
Frequently Asked Questions
Does TRICARE cover me if I live in Guatemala?
Yes, if you are TRICARE-eligible. TRICARE For Life (TFL) is described by tricare.mil as Medicare-wraparound coverage available worldwide, regardless of age or place of residence. TRICARE Select Overseas covers retirees and their families in all overseas areas, with enrollment required. Guatemala falls in TRICARE’s Latin America and Canada region, served by International SOS.
Do I need to keep Medicare Part B if I live in Guatemala with TRICARE For Life?
Yes, according to TRICARE. Its TFL page says that if you live overseas, you must have Medicare Part B to remain eligible for TRICARE even though Medicare doesn’t provide coverage overseas. International SOS adds that this applies when the sponsor is retired and you are entitled to premium-free Part A on your own or your spouse’s record. The 2026 standard Part B premium is $202.90 a month, per medicare.gov.
Who pays first for care in Guatemala, Medicare or TRICARE?
TRICARE. tricare.mil says Medicare doesn’t provide coverage outside the U.S. and U.S. territories, so in any other overseas location, whether you live there or are travelling, TRICARE is the primary payer and you pay TRICARE’s annual deductible and cost-shares. For TFL in 2026 that deductible is $150 per person or $300 per family, with a $3,000 yearly catastrophic cap per family.
What does TRICARE Select Overseas cost a retiree in 2026?
It depends on your group. tricare.mil’s 2026 table lists, for TRICARE Select, an annual enrollment fee of $186.96 per individual or $375 per family for Group A retirees (sponsor’s service began before 1 January 2018), and $594.96 or $1,191 for Group B. The Group A deductible is $150 per person or $300 per family; Group B’s is $198 network or $397 non-network per person. If you have TRICARE For Life, the Select enrollment fee does not apply to you.
Will a Guatemalan hospital bill TRICARE directly?
International SOS says that with TFL or TRICARE Select Overseas you should expect to pay up front and submit a claim to the TRICARE Overseas Program claims processor. It also warns that outside the U.S., nonparticipating non-network providers can charge any amount, and you pay anything above the TRICARE-allowable charge as well as your deductible and cost-shares.
How do I file a TRICARE claim for care in Guatemala?
Fill in DD Form 2642, attach a copy of the provider’s itemized bill, a short description of why you needed care, and proof of payment, then submit it online or mail it to TRICARE Overseas Program, PO Box 7985, Madison, WI 53707-7985. International SOS requires a Proof of Payment Attestation Form when you paid a provider $10,000 or more.
Is there a toll-free TRICARE number in Guatemala?
No. International SOS’s Guatemala contact page, read 2 October 2026, lists customer service and medical assistance toll-free numbers as not available. It gives regional direct numbers instead: +1-215-942-8393 for customer service and +1-215-942-8320 for medical assistance.
