Changes coming to TRICARE pharmacy benefit

By CourtesySeptember 2, 2015

Changes coming to TRICARE pharmacy benefit
A new law going into effect Oct. 1, 2015, requires most TRICARE beneficiaries to get brand name maintenance drugs from TRICARE Pharmacy Home Delivery or a military pharmacy. If beneficiaries keep using a retail pharmacy for these drugs, they will hav... (Photo Credit: U.S. Army) VIEW ORIGINAL

FORT HUACHUCA, Ariz. (Sept. 1, 2015) -- A new law going into effect Oct. 1, requires most TRICARE beneficiaries to get brand name maintenance drugs from TRICARE Pharmacy Home Delivery or a military pharmacy.

If beneficiaries keep using a retail pharmacy for these drugs, they will have to pay the full cost. Active-duty service members are exempt from the law's requirement.

Maintenance drugs are those you take regularly for a long time, such as drugs to control blood pressure or cholesterol. The law doesn't apply to drugs you take for a short time, like antibiotics, or generic drugs. The law also doesn't apply to beneficiaries living overseas, or who have another insurance plan with prescription drug coverage.

"The advantage of using military pharmacies, such as the one at Raymond W. Bliss Army Health Center [RWBAHC], for TRICARE beneficiaries is in a significant cost savings for maintenance medications," said Teresa Nord, the RWBAHC pharmacy chief. "At RWBAHC, there is no co-pay for up to a 90-day supply."

TRICARE beneficiaries can call 1-520-533-2520 to find out if their medication is available at RWBAHC.

To sign up for home delivery of certain medications, TRICARE beneficiaries can visit the Express Scripts website.

Beneficiaries affected by the change will soon get letters from Express Scripts, Inc., the TRICARE pharmacy contractor. These letters will tell beneficiaries they are taking an affected drug and explain their options. Beneficiaries can also call Express Scripts at 1-877-363-1303 to see if they are affected.

After Oct. 1, Express Scripts will send another letter to beneficiaries, who continue using a retail pharmacy for affected drugs.

After that, beneficiaries have one more chance to fill these prescriptions at a retail pharmacy before they have to pay 100 percent of the cost of their medication.

TRICARE Pharmacy Home Delivery is a safe, convenient and low-cost option to get maintenance drugs. Subscribers can get up to a 90-day supply, as opposed to a 30-day supply from a retail pharmacy, and it offers a $176 savings per year on co-payments for every brand name drug switched to home delivery.

For more information about this change to TRICARE's pharmacy benefit, visit its website.

Related Links:

Army.mil: Health News

TRICARE Pharmacy Program

TRICARE - New Rules