Changes coming to TRICARE pharmacy benefit

  • Published
  • By TRICARE staff report
  • Defense Health Agency
HOLLOMAN AIR FORCE BASE, N.M. --  Starting 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.

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

Maintenance drugs are those patients take regularly for a long time, such as drugs to control blood pressure or cholesterol.

The law does not apply to drugs taken 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, will send a letter to beneficiaries taking an affected drug and explaining their options.

Beneficiaries can contact Express Scripts at 1-877-363-1303 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.

The TRICARE Pharmacy Home Delivery is a safe, convenient and low cost option to get maintenance drugs. Customers can get up to a 90-day supply, as opposed to a 30-day supply from a retail pharmacy. Customers can save up to $176 a year for every brand name drug they switch.

Military pharmacies offer up to a 90-day supply of drugs at zero copay.

Customers can check with the Holloman AFB Pharmacy to see if they carry their prescription, or they can go online to http://online.lexi.com/lco/action/home to download or view a list of formulary medications.

Pharmacy customers are asked to, please, keep in mind even if their medication is not listed, the Holloman pharmacy still may be able to order it through their Special Order Program.

Pharmacy customers are encouraged to feel free to stop by the pharmacy or call them at (575) 572-2778, option 4.

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