Health & Safety

February 15, 2013

New pharmacy copays in effect

pharmacy-copayThe Fiscal Year 2013 National Defense Authorization Act requires TRICARE to increase copays on brand name and non-formulary medications filled outside of military hospitals and clinics.

This increase is effective immediately and does not apply to generic medications.

Copays vary based on the class of drug and where the prescription is filled. The new copay for a 30-day supply of brand name medication purchased at a retail network pharmacy has increased from $12 to $17. Beneficiaries using TRICARE Pharmacy Home Delivery will see an increase from $9 to $13 for a 90-day supply of medication.

The greatest change in copays applies to non-formulary medications, which have increased from $25 to $44 at retail pharmacies and $43 through Home Delivery. Future Fiscal Year increases will be the same as the retiree cost-of-living adjustment. In years when the increase would be less than $1, it will be delayed a year and combined with the next adjustment so increases will always be $1 or more.

If you have any questions regarding your pharmacy benefits, please contact Managed Care at (661) 277-6969 or visit www.TRICARE.mil/pharmacycosts.

 




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