Changes Coming to TRICARE Pharmacy Benefit By: TRICARE
Falls Church, Va, September 1, 2015 - Starting October 1, 2015, 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. Beneficiaries who keep using a retail pharmacy for these drugs will have to pay the full cost.
Maintenance drugs are those you take regularly for a long time, such as drugs to control blood pressure or cholesterol. The law does not apply to drugs you 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 contact Express Scripts at 1-877-363-1303 to see if they are affected.
After October 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. You can get up to a 90-day supply, as opposed to a 30-day supply from a retail pharmacy. You save up to $176 a year for every brand name drug you switch to Home Delivery. Military pharmacies offer up to a 90-day supply of drugs at zero copay, but not all drugs are available. You can check with your local military pharmacy to see if they carry your prescription.
For more information about this change to TRICARE's pharmacy benefit, visit www.tricare.mil/RxNewRules.