How does Medicare Part D work with other insurance companies? Pt 3

How does Medicare Part D work with other insurance companies? Pt 3

How can Medicare Part D work with Tricare for Life (TFL)?

Generally, prescription drug insurance under the TFR program for retirees and their dependents is “creditable” (as good as average Medicare Part D insurance). In general, you can enroll in a Medicare policy that insures you for your Part D prescription drugs without the risk of losing TFL’s medical or prescription drug supply.

In the future, if you drop or lose your TFL prescription drug delivery and enroll in a Medicare policy that includes Part D prescription drug insurance, you will not normally pay penalty for delay unless you do so for more than 63 days. How can Medicare Part D work with the Department of Veterans Affairs Health Program?

Veterans enrolled in the health program of the US Department of Veterans Affairs (VA). They can usually participate simultaneously in the VA Pharmacy Program and in a Medicare Part D Prescription Drug Policy, without their VA medical benefits or lose prescription drugs. You can use your VA benefits or your Part D prescription drug policy, but not both prescription drug coverage sources for the same prescription.

The VA pharmacy program and Medicare do not coordinate benefits. Should you for any reason lose insurance in the VA Pharmacy Program, you can usually enroll in Medicare Part D and you will not be charged for late enrollment as long as your Medicare Part D insurance begins within 63 days of losing VA insurance. The same rule applies if you are enrolled in the VA program for dependants of persons disabled or murdered while in active service.

How Medicare Part D may work with Medicaid

If you are eligible for both Medicare and Medicaid, you must receive your drug insurance through Medicare Part D and not Medicaid. You can automatically qualify for Extra assistance (also known as a Low Income Grant), and you generally have no risk of claiming late enrollment for Part D. If you do not enroll in the Medicare Prescription Drug Policy when you first qualify for Medicare, Medicare will enroll you in a policy so you always have prescription drugs.

How can Medicare Part D work with Medicare supplemental policies (Medigap)?

Policies for standard Medicare supplements sold today do not include coverage for prescription drugs. If your Medicare supplemental policy does not include coverage for prescription drugs, you can enroll in a separate Medicare Part D prescription drug policy. Standard Medicare supplemental policies, available in most states, cannot coordinate benefits to pay D premiums, deductibles, co payments or other expenses.

Non-network providers and non-contracted providers are not required to manage members of the Preferred Provider Organization (PPO), except in emergency situations. To decide if a provider insures an out-of-network service, it is recommended that you or your provider ask your policy to identify an organization that will provide the service before you will benefit from the service.  Call your policy’s customer service number or contact your proof of insurance for more information, including the cost sharing that applies to services out-of-network.

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