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Tricare for Life Question


DJW

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Both the DW and I are turning 65 next month and are signed up for Part B of Medicare and Tricare for Life. DW has retained a new Doc here in Bella Vista, AR. I will continue to use the VA. Went down on Tuesday to the VA hospital in Fayettaeville, AR and updated all my information from 15 years ago. I was still in the their system as I am 50 percent. Waiting for my primary care Team/Doc to be assigned in the next couple of weeks. DW will continue to use Express Script for her prescriptions. Here is my question:

 

DW goes to Doc and has some type of infection? She needs to go to Walgreens to get some type of antibiotic for it and start on it right now. She cannot wait to send to Express Script to start. I know we get our prescriptions free but we need to go through Express Script. In this case does Tricare for Life pay the 20 percent that Medicare does not?

 

Dennis

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First of all Walgreen's does not co operate\accept with Triare so pick another pharmacy.

For prescriptions you will only use the Tricare part. There for you will have a copay.

Not all of your RX thru Express Scripts will be free. If you are on a non formulary drug there will be a copay as well. Ron has a drug that he pays $16 for a 90 day supply. When I still took Estrogen it cost me $40 \90 day

Ron only uses VA for an annual checkup and hearing aids. Otherwise we both use private Dr. No money out of our pocket. Do be certain that for annual labs and mammogram you abide by the 365 day rule. Otherwise you will pay out of pocket. Also for thungsd like colestrol screenings there a diagnosis code pertaining to a diagnosis. Otherwise neither will pay for that

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Nan

 

A: It was a Hypothetical Question. We never use Walgreens but thanks for the info.

 

B: All of DW Med's are free no copay's and have been for 15 years

 

C. Good info for the 365 day thing

 

D. Will make sure that those type of screenings are coded for diagnosis

 

Stan

 

Thanks for the info.

 

Dennis

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We use the Barksdale AFB base pharmacy here. We have a great Brookshire's pharmacy midway between us and the Base/town for emergent weekend scripts we need filled that takes Tricare just fine. I was not aware that Walgreen's did not fill Tricare prescriptions! Good info Linda. Thanks.

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We use Express Scripts for all our regular meds ($16/90 day supply for two meds is the highest copay - everything else is "free"). Just had to pick up an antibiotic for my wife on Thursday - took the Rx to Walmart and the copay was $3.20. We use the WalMart pharmacy three minutes from the house for all PRN/ad hoc meds without any issues. Express Scripts for everything else.

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It is sometimes frustrating to find folks that take TRICARE, I needed a shingles shot and a tetanus booster, doctor couldn't give them to me without a $50 plus co-pay each.

 

Hit a few different places like Wallgreens, CVS and WalMart and they were either not available or not covered.

 

Getting frustrated we stopped at a Safeway for coffee and decided to walk back to the pharmacy there to see if they had a suggestion on where to go. Turns out they took TRICARE and had both available. Problem solved and they are now at the top of our list for any other shots we need.

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I'm confused as to why someone on TFL would want to use the VA. With TFL, you can choose any doctor that accepts Medicare (almost all), change if you don't like them, and travel freely throughout the US (like we do) without worrying about finding a VA clinic. We've never paid more than the annual $147 Medicare copay since TFL kicked in. Like others, we use Express Scripts for maintenance meds, and Wal-Mart or Safeway for one-time scripts. My BIL is a vet, not retired, low income, no insurance, and uses the VA which provides him great service, and which without, would leave him without any medical care. The problem is the extraordinary wait times. I wonder if more TFL-eligible retirees stopped using the VA if those without any other choice would be better served.

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Brenda

 

I will continue to use the VA over Medicare/Tricare for Life because unlike so many others the VA has treated me like gold since I retired in 1993. We have bought another home in Bella Vista, AR so I went down to the VA in Fayetteville, AR last Tuesday to get all my info up to date as I had not used them since 2001. I was still in the system as I have 50 percent rating. I asked to be assigned to a specific team/doc and they said they would do there best to make that happen. I was in and out of the admin office within 15 minutes. They indicated that I should get a letter within a couple of weeks assigning me a primary care doc. I sent my VA Doc in HI a secure message this morning asking him to refill a couple of prescriptions for me, not an issue. I will keep the Medicare/Tricare for Life in my back pocket for when we travel. The VA has been good to me and I try to never miss a chance to tell them thank you.

 

Dennis

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