Health & Safety

October 23, 2015

Ask the Doc

99th Medical Group

Q: My mom is a surviving spouse using TRICARE for Life. If she gets a Medicare Part D plan through my late father’s workplace insurance, will it affect her TFL drug prescription benefits?
A: Yes, having Part D definitely will affect her TFL prescription drug benefit. For most TRICARE beneficiaries, there is almost zero advantage to enrolling in a Medicare Part D prescription drug plan. The only TRICARE beneficiaries likely to achieve any financial advantage from Part D are those whose incomes are below the federal poverty level and who qualify for financial aid to help pay their Medicare Part B premiums. If your mom is not in that group and signs up for Part D, TRICARE would pay second after Medicare on her prescription drug claims — but that wouldn’t be automatic; she would have to file separate claims with TRICARE to be reimbursed for the Part D plan’s drug co-payments and deductibles. More important, TFL beneficiaries who enroll in Part D are locked out of the TRICARE Mail-Order Pharmacy program, which offers the lowest co-pays and greatest convenience of any TRICARE prescription drug option.

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