I turn 65 in Oct. I don't plan/need any additional supplemental insurance. Tricare for Life will do the job.

Your medication(s) were processed by the retail pharmacy using the Maximum Allowable Cost (MAC). This is a pricing strategy which establishes maximum retail provider reimbursement for multisource products, on a product-by-product basis.

The process used to calculate costs to TRICARE and the beneficiary are as follows:

1. The total cost or billed charge of the claim is determined by calculating the Maximum Allowable Cost paid by the (OHI) and the patient copay.

2. TRICARE determines how much they would pay if they were the Primary Payer; this amount is calculated by determining the drug cost and then subtracting the applicable TRICARE copay. This is the TRICARE Maximum Allowable Cost.

3. Reimbursement to the pharmacy and the remaining copay to the beneficiary are determined by the billed charge and the amount remaining after the primary coverage (OHI) has paid its benefits.

If the amount due is less than the TRICARE Maximum Allowable Cost, TRICARE will reimburse the pharmacy up to the remaining amount. The beneficiary will have no copay.

If the amount due is greater than the TRICARE Maximum Allowable Cost, TRICARE will reimburse up to the Maximum Allowable Cost. The beneficiary will be responsible for the remaining cost up to their TRICARE copay.

If the (OHI) paid amount is greater than the TRICARE Maximum Allowable Cost, no further reimbursement is due the pharmacy. The beneficiary will have no copay.

As an example for your claim the amounts can vary based on the contracted price at the time of filling:

Date of Service: 01/20/20
Ingredient Cost Submitted: $537.58
Cost Approved: $418.10
Primary Payer Amount Recognized/Approved: $346.53
Tricare billed: $71.67
Total Member's Cost: $0.00

Also, a lot of folks like the "Advantage" plans and that is fine. It has restrictions on doctor selection and facility selection. "Medigap" may make more sense. A little more pricey but you can see whoever you want. Again, it is a matter of cost.

Congrats on reaching 65!!!

If you are still working and have insurance you only need to get part A. Its no cost.
Within 30 days, they told me prior is best, of losing your insurance you need to get on part B. Failure to do that in this time period may increase your cost for the rest of your life.

If you are already drawing SS they automatically sign you up for part A.

Am I the only one here who isnt old?