As of Oct. 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 drugs you take regularly for a long time, such as to control blood pressure or cholesterol. The law does not apply to drugs you take for a short time, like antibiotics, or generic drugs. If you live overseas, or have other prescription drug coverage, you are not affected.
The TRICARE pharmacy contractor, Express Scripts, sent a letter to affected beneficiaries in September explaining their options. Beneficiaries can contact Express Scripts at 1-877-363-1303 if they have any questions.
Now, beneficiaries who fill an affected drug at a retail pharmacy will get another letter from Express Scripts. 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’ll save up to $176 a year for each brand name drug you switch from retail to Home Delivery. If you want to use a military pharmacy, make sure to check first to see if they carry your prescription. For more about this change to TRICARE’s pharmacy benefit, visit www.tricare.mil/RxNewRules.