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Fees go up Feb. 1 for off-base Rx services

By: tom philpott Military Update
January 28, 2018 Updated: January 28, 2018 at 4:05 am
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tom philpott, 

Tricare beneficiaries will see increases in co-payments for prescription drugs filled by mail order or at neighborhood retail outlets starting Thursday.

The prospect of higher out-of-pocket costs at these venues is expected to drive more beneficiaries to use on-base pharmacies where prescription drugs will continue to be dispensed free.

Of fee increases set to take effect next week, said David W. Bobb, chief of the Defense Health Agency's Pharmacy Operations Division, "what will have the greatest impact, not only on the program but on our beneficiaries, is the $7 copay that's going to be implemented for generic drugs through the mail order program."

For years, mailed generic drugs had been free to Tricare users. Prescription fees will climb only "a small amount" for brand-name and nonformulary drugs procured off base, Bobb added. That's why the new copay for mail order generics is most likely to affect beneficiary behavior. On-base pharmacies will become more popular. Retail outlets will fall more out of favor compared to base-run pharmacies and Tricare home delivery.

Prescriptions filled by mail are for 90-day supplies. Besides the new $7 copay for generics, mail-order copays will rise from $20 to $24 for brand name on the military formulary and from $49 to $53 for nonformulary brand names.

Prescriptions filled in the Tricare network of retail pharmacies are for 30 days. Those copays will increase from $10 to $11 for generic drugs, from $24 to $28 for formulary brand names and from $50 to $53 for nonformulary.

In some cases, survivors of active-duty service members may be eligible for lower cost-share amounts, officials said. Brand-name drugs not on the formulary are not available at base pharmacies unless deemed medically necessary.

Spokespeople for the Army, Navy and Air Force surgeons general confirmed that on-base pharmacy outlets expect to become busier.

Base pharmacies will "monitor prescription workload and adjust staffing and operations to meet demand," said Angela Ciancio for Navy's surgeon general.

In fiscal 2017, prescription costs for the Defense Department totaled $7.54 billion.

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To comment, write Military Update, P.O. Box 231111, Centreville, VA, 20120 or email milupdate@aol.com or twitter: Tom Philpott @Military_Update

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