TRICARE for Life (TFL) TRICARE for Life (TFL) is the health insurance program for Medicare-eligible military retirees and their dependents. They must be enrolled in Part A and Part B to receive the benefits. It pays secondary to Medicare and covers out-of-pocket costs including deductibles, coinsurances, and copayments. TFL also offers a pharmacy program that provides creditable drug coverage. offers a pharmacy program that provides creditable drug coverage. This means that if you are enrolled in the TFL pharmacy program, you can delay Part D Part D, also known as the Medicare prescription drug benefit, is the part of Medicare that provides prescription drug coverage. Part D is offered through private companies either as a stand-alone plan, for those enrolled in Original Medicare, or as a set of benefits included with a Medicare Advantage Plan. enrollment without incurring a late enrollment penalty (LEP). Be sure to compare the costs and benefits of Part D and your TFL pharmacy program to decide which best suits your needs.
If you are eligible for Extra Help, you may want to consider enrolling in Part D. The drug copayments for individuals who have Part D and Extra Help are typically lower than copays in the TFL pharmacy program. However, TFL’s formulary may be broader than the formularies of Part D plans offered in your area. You may also want to keep TFL’s pharmacy program if the plan covers your drugs with no or fewer coverage restrictions Coverage restrictions, also called Utilization Management Tools or formulary restrictions, are restrictions that a health or drug plan may place on certain covered services to limit their usage. Coverage restrictions include prior authorization, quantity limits, and step therapy. than available Part D plans. The TFL pharmacy program may also cover medically necessary Medically necessary refers to procedures, services, or equipment that meet accepted medical standards and are necessary for the diagnosis and treatment of a medical condition. drugs not on its formulary for a higher copay.
If you enroll in both Part D and TFL’s pharmacy program, Part D is the primary payer for your prescription drugs.