Changes Coming to TRICARE Pharmacy Benefit

SHAW AIR FORCE BASE, S.C. -- 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, 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 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; up to a 90-day supply, as opposed to a 30-day supply from a retail pharmacy. Saving up to$176 a year for every brand name drug switched to Home Delivery. Military pharmacies offer up to a 90-day supply of drugs at zero copay, but not all drugs are available.

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