An official website of the United States government
Here's how you know
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

News | July 27, 2023

Understanding Medicare Part D and TRICARE Pharmacy Coverage

By TRICARE Communications

You may already have TRICARE For Life (TFL). Or perhaps you’re eligible to transition to this coverage soon. Either way, you may have questions about your TRICARE prescription drug coverage. For instance, you may wonder if you need to have Medicare Part D, Medicare’s prescription coverage. You don’t need Medicare Part D to have TFL. That’s because TFL has the same prescription drug coverage as other TRICARE health plans. (This doesn’t include the US Family Health Plan.)
 
“While you’re required to have Medicare Part A and Part B to have TRICARE For Life, as long as you have TFL, you have TRICARE prescription drug coverage,” said Anne Breslin, TRICARE For Life program manager with the Defense Health Agency. “If you have TFL, there’s almost no advantage to signing up for Medicare Part D.”
 
Here are some common questions about pharmacy coverage through TFL and Medicare. Use the answers to help guide you to the best decision for yourself or your family member.
 
Q: Do I have pharmacy coverage when I transition to Medicare and TFL?
A: Yes. As outlined in the TRICARE and Medicare Turning Age 65 Brochure, if you’re eligible for TRICARE and have Medicare Part A and Part B, you’re automatically covered by TFL. And if you have TFL, the TRICARE Pharmacy Program provides your prescription drug coverage. This is creditable drug coverage that pays at least as much as Medicare’s standard prescription drug coverage.
 
Your TRICARE pharmacy coverage will continue seamlessly when you transition to Medicare and TFL from a TRICARE health plan. This is especially helpful if you have maintenance drugs that you take regularly for a chronic condition.
 
Q: When should I consider getting Medicare Part D in addition to my TRICARE pharmacy benefit?
A: Before you sign up for Medicare Part D, compare Medicare prescription drug plans and costs with the TRICARE pharmacy benefit. Keep in mind, the TRICARE Pharmacy Program has no monthly premium. Most people pay a monthly premium for a Medicare Part D plan. Also, take into consideration:
  • Deductibles
  • Copayments
  • Coverage and costs of drugs you already take (costs may vary based on which medications you take)
 
Q: What if I need help paying for Medicare Part D coverage?
A: If you have limited income and resources, you may want to consider Extra Help. Extra Help is a Medicare program to help people pay Medicare drug program costs, like premiums, deductibles, copayments, and coinsurance. Some people automatically qualify for Extra Help. You may automatically qualify if:
  • You have both Medicare and Medicaid
  • You’re in a Medicare Savings Program
  • You get Supplemental Security Income benefits
 
If you don’t automatically qualify for Extra Help, you can apply.
 
Q: How do Medicare Part D and TRICARE Pharmacy Program coverage work together?
A: If you have both Medicare Part D and TFL, Medicare is the primary payer. TRICARE pays last.
 
Q: Where can I fill my prescriptions?
A: If you have Medicare Part D, follow your Medicare prescription drug plan’s rules for getting your prescriptions. If you have TFL and don’t have Medicare Part D, you have the following TRICARE pharmacy options to fill your covered prescriptions:  
Q: Are there resources to help me manage my TRICARE prescriptions?
A: To help manage your prescription drug coverage, you can:  
Express Scripts is the TRICARE pharmacy contractor. If you need help or have questions, call 1-877-363-1303.
 
Q: If I decide to, when can I enroll in Medicare Part D?
A: You can enroll in a Medicare Part D plan during your Medicare Initial Enrollment Period, the Medicare Part D Annual Open Enrollment (Oct. 15–Dec. 7 every year), or during a Medicare Part D Special Enrollment Period. Having TRICARE pharmacy coverage makes you eligible for the special enrollment period. In this case, you won’t pay the late enrollment premium penalty.  
 
For more information about Medicare Part D prescription drug coverage, go to Medicare or call 1-888-633-4227. To learn more about Medicare and your TRICARE benefits, check out Becoming Medicare-Eligible.
 
Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.
Uniformed Sailor wearing glasses gives shot to another Sailor sitting down.

Learn How To Get Your TRICARE Vaccines Overseas

News
Aug. 28, 2024

Flu season is right around the corner—which means it’s time to start thinking about getting vaccines for...
Read More
Uniformed service member stands in pharmacy and reaches for to high shelf for box of medication.

Your Guide to TRICARE Pharmacy Program Terms

News
Aug. 22, 2024

Do you have a new prescription you need to fill? Or maybe you’ve been taking the same drug for years. Knowing...
Read More
Two hands search through manila folders in file cabinet.

TRICARE How-To: Filing Claims and Reimbursements

News
Aug. 20, 2024

Have you ever had to get care while traveling? Or maybe you’ve had to visit a non-network TRICARE-authorized...
Read More
Graphic of moving boxes filled with picture frames and books. Text reads, "TRICARE Webinar: Moving, Marriage, and More: What TRICARE QLEs Mean for You. Aug. 22, 2024, 3 to 4 p.m. ET"

Learn About TRICARE Qualifying Life Events at Au...

News
Aug. 15, 2024

Join TRICARE Thursday, Aug. 22, from 3 to 4 p.m. ET for the “Moving, Marriage, and More: What TRICARE QLEs...
Read More
Uniformed service member stands outside and holds infant in his arms.

Unlock Your Health With TRICARE Tips for Managin...

News
Aug. 13, 2024

When was the last time you checked to see if your information in the Defense Enrollment Eligibility Reporting...
Read More
Provider wearing white lab coat flips through papers with charts on clipboard.

The HIPAA Privacy Rule and Military Health Care:...

News
Aug. 06, 2024

Are you the parent or legal sponsor of a minor child? If so, there are things you should know about what...
Read More
Woman wearing white sweater stands outside and looks at smartphone.

TRICARE Fraud Alert: TRICARE For Life Phishing Scam

News
Aug. 06, 2024

If you’ve recently gotten a suspicious text message about your TRICARE coverage, don’t respond. Instead,...
Read More
An airman holds a smiling young girl.

TRICARE Coverage for Your Children: What You Nee...

News
Aug. 01, 2024

Are you wondering if your child has TRICARE coverage? Most children of service members and retirees can get...
Read More

Aug. 28, 2024

Learn How To Get Your TRICARE Vaccines Overseas

Flu season is right around the corner—which means it’s time to start thinking about getting vaccines for common respiratory diseases. If you live or travel overseas, it’s important to know where you can get these vaccines.

Aug. 22, 2024

Your Guide to TRICARE Pharmacy Program Terms

Do you have a new prescription you need to fill? Or maybe you’ve been taking the same drug for years. Knowing these TRICARE Pharmacy Program terms can help you get the medications you need at the right price.  

Aug. 20, 2024

TRICARE How-To: Filing Claims and Reimbursements

Have you ever had to get care while traveling? Or maybe you’ve had to visit a non-network TRICARE-authorized provider who doesn’t “participate.” In these situations—and some others—you might need to file a claim with TRICARE to get reimbursed.

Aug. 15, 2024

Learn About TRICARE Qualifying Life Events at Aug. 22 Webinar

Join TRICARE Thursday, Aug. 22, from 3 to 4 p.m. ET for the “Moving, Marriage, and More: What TRICARE QLEs Mean for You” webinar.

Aug. 13, 2024

Unlock Your Health With TRICARE Tips for Managing Your DEERS Record

When was the last time you checked to see if your information in the Defense Enrollment Eligibility Reporting System is up to date? If it’s been a while, take time to log in to DEERS and review your information.

Aug. 6, 2024

The HIPAA Privacy Rule and Military Health Care: What Parents of Minors Need To Know

Are you the parent or legal sponsor of a minor child? If so, there are things you should know about what access you have to your child’s health care records and choices. The Health Insurance Portability and Accountability Act Privacy Final Rule protects minors’ privacy concerning their health care choices and treatment.

Aug. 6, 2024

TRICARE Fraud Alert: TRICARE For Life Phishing Scam

If you’ve recently gotten a suspicious text message about your TRICARE coverage, don’t respond. Instead, report it to TRICARE.

Aug. 1, 2024

TRICARE Coverage for Your Children: What You Need To Know

Are you wondering if your child has TRICARE coverage? Most children of service members and retirees can get TRICARE until they turn age 21 (or 23 if they’re in college).

July 30, 2024

Getting Telemedicine Care Overseas With TRICARE

Do you live overseas and need health care? You may be able to get telemedicine care from the comfort of your home.

July 25, 2024

Your TRICARE Guide to Overseas Travel

Planning a trip overseas? Whether you’re traveling for work or leisure, it’s a good idea to know how your TRICARE plan works outside the United States.