The drug cost comparator: three benefits, your list, one answer
This calculator prices a year of your prescriptions under all three veteran drug benefits: VA pharmacy at $5/$11 tiers under the $700 cap, TRICARE's Express Scripts at 2026's $14/$44/$85 home-delivery rates, and a Part D plan at stated typical-plan assumptions capped at $2,100 — then names the cheapest route and what it saves.
Drug cost comparator: VA vs. Express Scripts vs. Part D
Count your ongoing prescriptions by type, and the calculator prices a year under each benefit — VA tiers under the $700 cap, Express Scripts at 2026 home-delivery rates, and a Part D plan at clearly stated typical-plan assumptions.
All three routes are creditable — no late penalty rides on this choice. VA prices require VA (or authorized community-care) prescribers and formulary coverage; most brand maintenance drugs on TRICARE must move to home delivery or a military pharmacy ($0); Part D copays, deductibles, and formularies vary by plan — these are modeled estimates, not quotes.
Estimates for educational purposes only — not a quote, plan recommendation, or guarantee of costs; actual costs vary by plan, pharmacy, and formulary. This website is not connected with or endorsed by the U.S. government or the federal Medicare program. For information on all of your options, contact Medicare.gov, 1-800-MEDICARE (TTY 1-877-486-2048), or your local State Health Insurance Assistance Program (SHIP).
What the model assumes — and what it can't
Each column uses published 2026 rates where they exist and labeled assumptions where they don't. VA: Tier 1 generics at $5 and brand/higher tiers at $11 per 30 days, the $700 annual copay cap, and $0 for copay-exempt veterans — real prices, contingent on the medication being on the VA formulary and VA-prescribed. Express Scripts: the post-January $14/$44/$85 per-90-day home-delivery schedule — exact, with military pharmacies at $0 where stocked as the unmodeled bonus. Part D: the one column that must estimate — a $38.99 monthly base premium plus typical tier copays ($8 generic / $47 preferred brand / $170 specialty), drug spending capped at $2,100, deductible exposure inside the cap, IRMAA excluded. Your county's actual plans will land above and below that model, which is exactly the verification an agent's formulary lookup provides.
Reading your result like a strategist
- VA wins big — the usual outcome for VA-prescribed lists, since the $700 cap is the worst case all year. The result holds only as far as the prescriber rule reaches: civilian scripts don't get VA prices.
- Express Scripts wins or ties — the TFL household's signal to leave well alone: any prescriber, no premium, no gap. A Part D plan would add cost without adding coverage.
- Part D close behind — worth attention only when the inputs say so: heavy civilian prescribing, a VA formulary gap, or full Extra Help (toggle it — subsidized Part D at $5.10/$12.65 copays beats almost everything for retail flexibility).
- Holding two columns at once is legal and common — VA + Express Scripts for the enrolled retiree, VA + Part D for the split-router. The calculator prices each lane; the comparison guide covers the routing strategy.
- Already paying for a column you don't use? An MAPD or PDP duplicating military coverage is the creditable coverage SEP's entire reason to exist.
Your fourth arrangement — free Meds by Mail generics plus OptumRx retail — beats every column above at $0, and adding the Part D column would end it. The calculator exists for the three benefits that compete; yours doesn't.
Frequently asked questions
How accurate is the Part D estimate?
Why does the VA column cap at $700?
Can I really use VA pharmacy and Express Scripts together?
Does choosing the 'wrong' one trigger a penalty?
You earned these benefits. Make them work together.
Whether you keep exactly what you have or add Medicare coverage alongside it, the right answer depends on your health, budget, and how you like to get care.
No cost, no obligation. You can also get help from Medicare.gov, 1-800-MEDICARE (TTY 1-877-486-2048), or your local SHIP office.