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TRICARE announces changes to its pharmacy benefit

By TRICARE.com | Marine Corps Logistics Base Albany | September 4, 2015


Beginning Oct. 1, a new law requires all TRICARE beneficiaries, except active-duty service members, to get select brand name maintenance drugs through either TRICARE Pharmacy Home Delivery or from a military pharmacy, according to an article from TRICARE’s website, www.tricare.mil/RxNewRules.

Beneficiaries who keep using a retail pharmacy for these drugs will have to pay the full cost.

Maintenance drugs are those individuals take regularly for a long time, such as drugs to control blood pressure or cholesterol. The law does not apply to drugs people take for a short time, like antibiotics or generic drugs.

Beneficiaries living overseas, or with other prescription drug coverage, are not affected.

The TRICARE pharmacy contractor, Express Scripts, is sending a letter to beneficiaries taking an affected drug, explaining their options. Beneficiaries can call Express Scripts at 877-363-1303 to see if they are affected.

After Oct. 1, beneficiaries still filling an affected drug at a retail pharmacy will receive another letter informing them of the change to the benefit. After that, beneficiaries have one final “courtesy” fill at a retail pharmacy. If they fill at a retail pharmacy again, 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. Beneficiaries can get up to a 90-day supply as opposed to a 30-day supply from a retail pharmacy. They save up to $176 a year for every brand name drug they switch to Home Delivery.

Military pharmacies offer up to a 90-day supply of drugs at zero co-pay, but not all drugs are available. Service members, retirees and family members can check with their local military pharmacies to see if they carry their prescriptions.

For more information about this change to TRICARE’s pharmacy benefit, visit www.tricare.mil/RxNewRules.