Pharmacy

• Should I enroll in Medicare Part D?No, for almost every TFL beneficiary. TRICARE Pharmacy (Express Scripts) is creditable coverage and cheaper than most Part D plans. Adding Part D usually costs more without adding benefit.
• Where can I fill prescriptions on TFL?MTF pharmacy (free), TRICARE Pharmacy Home Delivery (Express Scripts, lowest copays for 90-day supplies), or any in-network retail pharmacy.
• What is 'creditable coverage' for Part D?Drug coverage that's at least as good as standard Part D. TRICARE Pharmacy is creditable, so you can skip Part D without owing a late-enrollment penalty later.
• What are the TRICARE Pharmacy copays for retirees?MTF pharmacy: $0. Home Delivery (90-day): low. Retail network (30-day): higher. Non-network: highest and requires a paper claim. Exact amounts adjust annually.
• What if my drug isn't on the TRICARE formulary?Non-formulary drugs cost more. Your doctor can request a medical-necessity exception so it's covered at the formulary copay.
• How do I get prescriptions filled while traveling?Use any in-network retail pharmacy (CVS, Walgreens, Kroger, etc.) — they're in the Express Scripts network nationwide. For long trips, request a vacation override.
• What is a pharmacy prior authorization?Some drugs (high-cost specialty, opioids, certain brand-names) require Express Scripts to approve before TRICARE will pay. Your doctor submits the request.
• How do I move a prescription to Home Delivery?Have your doctor send a 90-day prescription to Express Scripts Home Delivery, or transfer it from a retail pharmacy through the Express Scripts app or 1-877-363-1303.
• Should I enroll in a Medicare Advantage plan that includes Part D (MAPD)?Only if the MA plan otherwise makes sense for you. The Part D piece duplicates TRICARE Pharmacy — but you keep TRICARE Pharmacy as a fallback. Don't enroll just for the drug coverage.

Educational only — not insurance, legal, or tax advice. Verify with Medicare (1-800-MEDICARE), WPS (1-866-773-0404), SSA, or a licensed advisor before making enrollment decisions.