Editor’s Note: This article is part of MOAA’s 2021-22 TRICARE Guide, brought to you by MOAA Insurance Plans, administered by Association Member Benefits Advisors (AMBA). A version of the guide appeared in the November 2021 issue of Military Officer magazine.
Normally, MOAA suggests not having multiple health-drug insurance plans. You pay two premiums for duplicate coverage, and it complicates claims administration.
If you have another drug plan, it must pay before the TRICARE pharmacy and you may have to file manual claims to TRICARE for additional drug reimbursements. And you will lose the TRICARE/Express Scripts home delivery program. If you do sign up for another drug plan, here’s what to know:
Express Scripts Coordination
The most efficient situation is when your other drug plan uses Express Scripts, as the TRICARE pharmacy does. Coordination of the two drug plans can be done internally within the Express Scripts organization. Call your other drug plan or read their literature to see who their drug contractor is.
When both of your plans use Express Scripts, let Express Scripts know at (877) 363-1303 to coordinate your two plans. Be sure to have the name of your other health plan on hand with the details. Ask your provider to e-prescribe your medications to Express Scripts Pharmacy. Remember, the TRICARE-Express Scripts coverage always pays last under pharmacy coverage.
If your other plan is not with Express Scripts, TRICARE Express Scripts home delivery is not available to you. Use a retail network pharmacy or other home delivery program specified by your other pharmacy benefit.
If you use a TRICARE retail network pharmacy, your other drug plan is the primary payer, and TRICARE is the secondary payer. You may have to file manual claims to TRICARE pharmacy for TRICARE payment after the other plan pays. TRICARE will become the primary payer when your other plan doesn’t cover your medication (assuming TRICARE covers the med), or you’ve used up your other benefit coverage for the year, or if the TRICARE coverage rules apply.
You can manage and follow your prescriptions using mobile apps or by going online. You can also set up an auto-pay feature. Download the Express Scripts Mobile App in the App Store or Google Play, or go online to Express-scripts.com/login.