Prescription Drug Coverage Comparison

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A pharmacy technician looks at the label of medication.
A pharmacy technician assigned to the 99th Medical Support Squadron looks at the label of medication while working in the Satellite Pharmacy at Nellis Air Force Base, Nevada, Sept. 19, 2019. (U.S. Air Force/Airman 1st Class Bryan Guthrie)

The difference in prescription drug coverage betweeen MEDICARE, VA, CHAMPVA and Tricare

 

  Medicare Prescription Drug Coverage (Part D) VA CHAMPVA Tricare
Who is eligible? All people with Medicare. All veterans who are eligible for, and enroll in VA health care coverage. Spouse, survivor, or child of certain veterans killed or disabled in the line of duty.  Active duty and retired military and dependents. If age 65 or older an individual must have Medicare Part B. 
Who fills prescriptions Participating pharmacies. Some plans may also offer a mail order option. May be filled at VA or civilian pharmacies or by mail May be filled at retail pharmacies or by mail May be filled at military treatment facilities, retail pharmacies or  Tricare Mail Order Pharmacy.
How much are premiums? $36 monthly national average for the premium (varies by plan) None None None
How much are copayments? (Note: Amounts may vary by plan.) $445 deductible, then 25% copayments until $4,130 total in drug spending.   $8 copayment for medication. VA limits drug copayments at $960 yearly for some veterans. $50 yearly deductible for all outpatient care, including pharmacy. Cost-share for retail pharmacy is 25%.  After $3,000 annual catastrophic limit is reached, CHAMPVA pays 100% . Military Treatment Facilities - up to a 90-day supply (formulary drugs only) at no cost. Retail pharmacies - up to a 30 day supply; $10 generic, $24 brand name, and $50 non-formulary copayment. Mail order pharmacy - up to a 90-day supply: free generic, $20 brand name, and $49 non-formulary copayment. .
Is help available for drug costs? Yes. Yes.  No.  No.

See our page that compares Medicare Part D and Tricare for more details.

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