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Understanding Military Medical Care

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Pharmacy

There are basically three ways to receive medications through Tricare:

Military Pharmacies. First, you may have prescriptions filled (up to a 90-day supply for most medications) at a military treatment facility (MTF) pharmacy free of charge. Please be aware that not all medications are available at MTF pharmacies. Each facility is required to make available the medications listed in the basic core formally (BCF). The MTF, through their local Pharmacy & Therapeutics Committee, may add additional medications to their local formally based on the scope of care at that MTF.

Tricare Mail Order Pharmacy (TMOP). You can order medications online or through the mail. You can receive up to a 90 day supply (for most medications). The cost is $3.00 per prescription/refill for generic drugs and $9.00 per prescription/refill for name-brand drugs.

You can get your medications through any civilian pharmacy. If the pharmacy is part of the Tricare Pharmacy Network, the cost is the same as the Mail Order Pharmacy. If your pharmacy is not part of the Network, Tricare will reimburse you $9 or 20% of total cost (whichever is greater). For users of Tricare Prime who use a commercial non-network pharmacy (why would you?) there is an annual deducible of $300 per person or $600 per family. For users of Tricare Standard who elect to use a non-network pharmacy, the annual deducible is part of the Tricare Standard annual deducible.

Effective 1 April 2001, retirees/family members over the age of 65 are also eligible for the above pharmacy benefits, but -- like Tricare for Life -- they must be enrolled in Medicare, Part B to participate. Cost-share is the same as shown above.

Active Duty/Reserve Dental Care

Dental Care for active duty, of course, is free through the Military Dental Clinic. Tricare does, however, offer optional dental plans for family members of active duty, and members of the Guard/Reserves and their family members. These programs require a monthly premium. The programs pay the total cost of some dental care, plus cost-share for other dental care. Current monthly premium rates are (2003):

  • Active duty - One family member, $8.11 per month. Two or more family members, $20.27 per month.
  • Selected Reserves - For the military member, $8.11 per month. For one family member, $20.27 per month. For more than one family member, $50.67 per month. For the military member and his/her family, $58.78 per month.
  • Individual Ready Reserves (IRR) - For the military member, $20.27 per month. For one family member, $20.27 per month. For more than one family member, $50.67 per month. For the military member and his/her family, $70.94 per month.

Retiree Dental Program

In addition to dental programs for family members and Guard/Reserve, Tricare offers a separate dental program for military retirees and retiree family members. The premiums for this program depends upon where you live, and number of family members covered. Like the other program, the Retiree Program covers 100 percent of some costs, with cost-share for other costs.

You can also enroll online for this program.

VA Medical Care

I run into folks all the time who think that any military retiree or any veteran can get free medical care from the Veterans Administration. Not true. To receive medical care from the VA, one must be a Veteran (over 180 days of military service), one must have an honorable discharge, and one must either have a service-connected illness, injury or disability, or one must fall into a certain range of poverty. More information about VA Medical Care is available on the VA's Web Site.

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