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Show r 12 June 7. 2001 'Other health insurance' affects pharmacy coverage benefits that do not cover all medications or cover Health Insurance Coverage Form if you are currently only certain types of prescription products. Many receiving or have received OHI benefits in the last won't cover products like Claritin, Allegra, Viagra five years. or fertility drugs at least some of which TRICARE If you're paying for a private supplement plan that may cover. For example, many OHI companies don't picks up the pharmacy costs not covered by TRI- cover Viagra, but TRICARE covers up to six tablets CARE, be aware that such supplements aren't counted every 30 days when medically appropriate. In this situation, you initially would have your preas OHI and don't need to be listed on the OHI form. Even if you keep your OHI, some plans may not scription processed by the network pharmacy through provide pharmacy coverage. In that case, you will your primary OHI carrier. If your OHI says it won't have several options: cover it, or will pay for only part of the prescription, you can pay the price"out of pocket and file a Obtain a letter stating this from your OHI paper claim with TRICARE for all but the amount This type of TRICARE claim cancarrier and provide a copy to Palmetto Gov- of the ernment Benefits Administrators, either directly not be processed electronically. On the paper claim, or through your TRICARE Service Center; you must attach a copy of the OHI's explanation of benefits, or a printed copy of the company's policy Provide a copy of the page from your benefit statement, and submit a copy of that information each time you submit a paper claim for that drug to booklet; or OHI ended. You will also need to complete the Other by Marty Kessler Chief, TRICARE Prime beneficiaries, or new beneficiaries that have done their homework, probably know that TRICARE isn't the primary payer for those who also have OHI "other health insurance." What they may not know is how this affects pharmacy coverage for beneficiaries who have both TRICARE Prime and OHI. As the secondary payer, TRICARE will review prescription costs not covered by OHI and pay in accordance with policy guidelines. Many TRICARE beneficiaries have OHI, but some may choose to cancel it when they enroll in TRICARE Prime. If, however, they go to a network retail pharmacy afterward and try to get a prescription filled as part of their TRICARE benefits, they may find that the prescription won't process under TRICARE. This happens when the computer database which is maintained by Palmetto Government BenSign the OHI questionnaire, stating under efits Administrators, TriWest Healthcare Alliance's penalty of perjury that your OHI does not cover subcontractor for claims accessed by the network pharmacy. pharmacy shows the OHI as still being active. If you cancel your OHI when you enroll in TRICARE Your file will be coded under TRICARE to show the Prime, be sure to complete the Other Health Insur- absence of OHI pharmacy coverage, and TRICARE ance Coverage Form during the TRICARE enrollwill be your primary payer for pharmacy costs. ment process, so the database will show the date the Other OHI carriers may provide limited pharmacy MAILHANDLERS . PREFERRED PROVIDERS Chiropractic Mf'Hirril Acupuncture PVnrcircil Thpranir Mw I V " ' 30-da- 90-da- TO' pru ill A AAA IAALIA1JAAA I ; "v infmsyy( ' UUjj One Step at a Time 1580 W. Antelope Refinance?: 175, Layton www.utaheycdoc.com Care Company S While rateS , .. LOW' r HHAAvN f f FREE LECTURE Wed., June 13 - 7 P.M. " MM' 728-023- 4 'I in Located at: Sa&le "Pcttcutcccd Inc. DOWN TO EARTH NATURAL FOOD ROY MT, 04067 LAYTON 2182 N. 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