Pharmacy rules changing in October

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  • By Staff Reports
  • 78th Medical Group
Beginning Oct. 1, TRICARE beneficiaries who take certain brand-name medications on a regular basis will be required to fill prescriptions at a military treatment facility or through a mail-in program, a Defense Health Agency official said.

George Jones, DHA's pharmacy operations division chief, said the new policy doesn't apply to active-duty troops, overseas beneficiaries, nursing-home residents and those with other health insurance which has a prescription-drug program.

In some circumstances, he added, beneficiaries could be waived from the program on an individual basis.

The brand-name, regularly used, or maintenance medications could include those to treat chronic conditions such as blood pressure or cholesterol issues, Jones explained.

Generic medications are not affected by the new policy, he said.

TRICARE pharmacy beneficiaries who will be affected will receive a letter from TRICARE in early to mid-September, with instructions on make the transition from retail pharmacies to a military pharmacy or the Express Scripts mail-in program, he said.

Those with questions about medications in the brand-name maintenance category can call Express Scripts customer service at 1-877-363-1303 or look up the drug online at TRICARE's website.

Beneficiaries can track their medication status and expected delivery date by calling or going online to Express Scripts.

The new TRICARE policy stems from the 2013 National Defense Authorization Act and is designed to save beneficiaries and taxpayers money, Jones explained.

"Based on estimates, the program is expected to save beneficiaries $16.5 million in reduced copays, and projected Defense Department savings is $88 million during the first year," he said.

That translates into a savings of about $176 per medication per year, he added. A pilot program on the new pharmacy initiative was conducted in 2014, and it was very successful.

"It was very well received by beneficiaries and met reductions in beneficiary-put-of-pocket costs and reduced costs to the government," he said.

The 78th Medical Group will hold its mandated Wingman Day event Oct. 16 from 11 a.m. to 4:30 p.m. During this time all medical group services, including the pharmacy and the central appointment line will be closed. The clinic doors will close at 11 a.m. and reopen Oct. 18 at 7 a.m. All clinic services will resume normal duty hours starting at 7:30 a.m.