New Copays for TRICARE Pharmacy Customers starting February 2013

  • Published
  • By Senior Airman Luis Loza Gutierrez
  • 319th Air Base Wing Public Affairs
GRAND FORKS AIR FORCE BASE, N.D. --  New copayments for prescription drugs covered by TRICARE will go into effect soon.
 
"The customers that we have polled at our counter have not heard anything and the copay increase starts February 2013," said Maj. Doreen M. Hinsz, 319th Medical Support Squadron pharmacy flight commander.

The Fiscal Year 2013 National Defense Authorization Act requires TRICARE to increase copays on brand name and non-formulary medications that are not filled at military clinics or hospitals. There is no increase to copays for generic medications.

TRICARE Pharmacy copays vary based on the class of drug and where beneficiaries choose to fill their prescriptions. The copay for generic medications stays at $5 when a prescription is filled at a network pharmacy. There is no co-pay when generic prescriptions are filled through TRICARE Home Delivery.

The new copay for a 30-day supply of a brand name medication purchased at a retail network pharmacy will be $17, up from the current $12. Beneficiaries using TRICARE Home Delivery will pay $13 for brand name drugs, up from $9. However, the Home Delivery price is for a 90-day supply.

"The biggest change in copays will apply to non-formulary medications," said Hinsz. "These are medications that are not included in the list of formulary or preferred medications that a committee of DoD (Department of Defense) pharmacists and doctors deems to be the safest, most effective and most economical. Over-the-counter medications are usually non-formulary as well."

The $25 copay for these drugs increases to $44 at retail pharmacies and $43 through Home Delivery. The TRICARE Uniform Formulary is a list of all the medications TRICARE covers.

For fiscal 2014 and beyond, the new law directs that copays increase annually by the same percentage as retiree cost-of-living adjustments. In years when a COLA increase would total less than a dollar, it will be delayed a year and combined with the next adjustment so increases will always be $1 or more.

Pharmacies at military hospitals and clinics will continue to provide medications with no copays.

Visit http://tricare.mil/costs/prescriptioncosts for more details.