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.
Female Uniformed Service Member looks at mammogram images on a monitor with a keyboard.

The Power of Prevention: Get Cancer Screenings W...

News
Apr. 09, 2024

Catching cancer early is one of the best ways to protect yourself and your loved ones from cancer. Routine...
Read More
Heart Health: BAMC incorporates lifestyle medicine into cardiac rehab program

Look After Your Heart With Help From TRICARE

News
Apr. 04, 2024

Keeping your heart healthy is important at every age. Catching heart disease early gives you the best chance...
Read More
Screenshots of the latest issue of the TRICARE Health Matters Dental Newsletter. Callout box with text says, "Catch up on the latest dental news! www.tricare.mil/newsletters"

Check Out the Latest TRICARE Dental Program News...

News
Apr. 02, 2024

The latest issue of the TRICARE Health Matters Dental Newsletter is now online. It's full of information about...
Read More
Woman in wheelchair looks at her daughter's phone

Q&A: How TRICARE Covers Durable Medical Equipment

News
Mar. 28, 2024

TRICARE covers a range of DME, so you and your family can make the most of this equipment if you need it.
Read More
Provider wearing white lab coat flips through papers with charts on clipboard.

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

News
Mar. 21, 2024

Are you the parent or legal sponsor of a minor child? If so, there are things you should know about what...
Read More
Collage image that displays the cover of the TRICARE Choices in the United States Handbook in front of other TRICARE handbooks.

Get To Know Your TRICARE Options in the U.S.

News
Mar. 20, 2024

Are you new to TRICARE and wondering what your health, dental, and vision coverage options are? If you live in...
Read More
Infographic including stick figure typing on laptop and a speech bubble with prescription bottle. Text reads "Military Health System MHS GENESIS - Refills are here!"

New Feature of MHS GENESIS Patient Portal Allows...

News
Mar. 15, 2024

The Defense Health Agency has launched a new feature that lets you request prescription refills through MHS...
Read More
Uniformed service member smiles and stands with wife and daughter at promotion ceremony.

Maintaining Your Military Health Records Overseas

News
Mar. 12, 2024

No matter where you live, it’s important for your electronic health record to be complete and up to date. For...
Read More

April 9, 2024

The Power of Prevention: Get Cancer Screenings With TRICARE

Catching cancer early is one of the best ways to protect yourself and your loved ones from cancer. Routine cancer screening tests can find many common cancers before they cause symptoms.

April 4, 2024

Look After Your Heart With Help From TRICARE

Keeping your heart healthy is important at every age. Catching heart disease early gives you the best chance for treatment to work well—and TRICARE makes it easy to get the preventive care you need.

April 2, 2024

Check Out the Latest TRICARE Dental Program Newsletter

The latest issue of the TRICARE Health Matters Dental Newsletter is now online. It's full of information about the TRICARE Dental Program and oral health.

March 28, 2024

Q&A: How TRICARE Covers Durable Medical Equipment

TRICARE covers a range of DME, so you and your family can make the most of this equipment if you need it.

March 21, 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.

March 20, 2024

Get To Know Your TRICARE Options in the U.S.

Are you new to TRICARE and wondering what your health, dental, and vision coverage options are? If you live in the United States, the TRICARE Choices in the United States Handbook is a great place to start.

March 15, 2024

New Feature of MHS GENESIS Patient Portal Allows Prescription Refills

The Defense Health Agency has launched a new feature that lets you request prescription refills through MHS GENESIS.

March 12, 2024

Maintaining Your Military Health Records Overseas

No matter where you live, it’s important for your electronic health record to be complete and up to date. For TRICARE Prime Overseas and TRICARE Prime Remote Overseas beneficiaries, there are processes that help make this possible.

March 11, 2024

DOD Amends Assisted Reproductive Services Policy for Severely Ill and Injured Active Duty Service Members

DOD amended its policy covering assisted reproductive technology services to expand access for severely ill and injured active duty service members.

March 7, 2024

See What’s in Store for the TRICARE Pharmacy Program in 2024

The most recent TRICARE pharmacy contract, known as TRICARE Pharmacy 5th Generation (TPharm5), started on Jan. 1, 2023. Since then, you may have experienced some enhancements to how you get your prescription drugs. In 2024, you can continue to expect improved access to pharmacy benefit services through the TRICARE Pharmacy Program.