Tricare Help: Drugs aren’t free, but pharmacy plan is still a great deal - Getting out, military health issues - Navy Times

Tricare Help: Drugs aren’t free, but pharmacy plan is still a great deal

Answering your questions on Tricare.

Q. I just got Tricare for Life. You have written that I don’t need Medicare Part D because the Tricare Pharmacy Program is free. That is not true. Prescription drugs are a little bit cheaper under Tricare for Life, but they are not free. I usually have to pay $9 for my medicines, and one time I had to pay $22.

A. I apologize if I unintentionally misled you. I should have clarified that the Tricare Pharmacy Program does not charge a monthly premium; you are correct that the drugs themselves are not free.

I would argue, though, that drugs under TFL are more than just “a little bit cheaper.” The next time you talk with your pharmacist, ask how much your prescriptions would cost if you did not have Tricare to help pay for them. A month’s supply of popular drugs like Lipitor, Lyrica or Nexium, for example, can easily run $100 or more.

Q. My wife, daughter and I are enrolled in Tricare Prime. I will soon be 65 and get Medicare and Tricare for Life. My wife is 10 years younger. What will happen to my family’s Prime enrollment when I get TFL? Will I continue to pay for Prime? How much will TFL cost me?

A When you get Medicare and are enrolled in Part B, you, personally, will automatically lose your Tricare Prime eligibility and be transferred to Tricare Standard. Your family’s Tricare Prime enrollment will not change.

The enrollment fee for Tricare Prime is $460 per year for a family of two or more. Thus, you will continue to pay that amount for your wife’s and daughter’s continued enrollment in Prime.

The Tricare Standard portion of your TFL eligibility is free, but you will have to pay a monthly premium for Medicare Part B.

There are no other costs for your TFL membership.

For the most part, the only change in the costs of your family’s coverage will be the addition of your monthly Medicare Part B premium.

Medicare will become your primary health insurance, and Tricare Standard will become second payer. You’ll have no out-of-pocket expenses for every item on your Medicare claim that is covered by both Medicare and Tricare Standard. The combined Medicare and Tricare payments will pay your Medicare claim and the provider’s bill in full.

Occasionally, you may have a Medicare claim with one or more items not covered by both Medicare and Tricare. On those claims only, you will have to pay any deductibles and co-payments associated with the plan that does pay for the particular item or items. Such claims will be uncommon.

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Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or e-mail tricarehelp@militarytimes.com. In e-mail, include the word “Tricare” in the subject line and do not attach files. Get Tricare advice anytime on the Tricare Help blog.