News>New co-pays for some TRICARE pharmacy customers
Photos
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. (U.S. Air Force graphic/Senior Airman Luis Loza Gutierrez)
2/1/2013 - LAUGHLIN AIR FORCE BASE, Texas -- New copayments for prescription drugs covered by TRICARE will go into effect Feb. 1. The fiscal year 2013 National Defense Authorization Act requires TRICARE to increase co-pays on brand name and non-formulary medications that are not filled at military clinics or hospitals. There is no increase to co-pays for generic medications.
"I want people to be aware of the difference," said Capt. Daniel Oh, 47th Medical Group pharmacists. "I especially want the beneficiaries who have multiple prescriptions to be aware of the new co-pay since the total price can be shocking if you don't know about the new changes."
TRICARE Pharmacy co-pays vary based on the class of drug and where beneficiaries choose to fill their prescriptions. The co-pay 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 co-pay 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.
"People who don't use the base pharmacy and would like to use off base pharmacies should expect higher co-pays," said Oh.
The greatest change in co-pays applies to non-formulary medications. The $25 co-pay 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 co-pays 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 co-pays. Visit www.TRICARE.mil/pharmacycosts for more details.
