TRICARE pharmacy benefit change coming

  • Published
  • By TRICARE
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 taken 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, such as 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 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. 

For more information about this change, visit www.tricare.mil/RxNewRules.