Tricare Changes Prescription Co-Pays

Ever wondered about the Tricare Prescription Home Delivery Program? Now is a good time to look into this easy way to fill ongoing prescriptions for chronic conditions, because the co-pay on generic drugs is dropping to $0 (yes, that is zero) on 1 October 2011. At the same time, co-pays for retail pharmacies will be going up slightly.

The Prescription Home Delivery Program is affordable and convenient, and can allow your doctor to prescribe medications that might not be available at your local pharmacy or military treatment facility.  The co-pay for name brand drugs via the home delivery program applies to a 90 day supply, a substantial savings over the 30 day supply co-pays for retail pharmacies.   Also, using the online pharmacy program allows you some privacy, especially if you live in a small town or are posted at a small military base.

Signing up isn’t too difficult, either. You will have to register each family member. When you click through to the registration page, be sure to see the note at the top that tells Tricare beneficiaries to click again to get to the Tricare page. Registration takes about 2 minutes per person, so that part isn’t hard.

Once you’ve registered, you’ll need to get your prescriptions into the system.  If you already have prescriptions that are being filled through a retail pharmacy and are being billed through Tricare, those prescriptions may already be in the system for you to switch to home delivery.  Otherwise, you can ask your doctor to write a 90 day prescription and either mail it or have your doctor fax it to the pharmacy program.

Other co-pay changes that will occur on 1 October 2011 include:

  • Generic formulary medications at retail pharmacies will increase from $3 to $5
  • Name brand formulary drugs at retail pharmacies will increase from $9 to $12
  • Non-formulary drugs at retail pharmacies and via the mail order program will increase from $22 to $25

Name brand formulary drugs obtained via the home delivery program will continue to have a $9 co-pay.

I have been thinking about switching our regular medication to the home delivery program in order to save time at the pharmacy, and now will be a great time to make that change.  You might consider it, too.

About the Author

Kate Horrell
Kate Horrell is a military financial coach, mom of four teens, and Navy spouse. She has a background in taxes and mortgage banking, and a trove of experience helping other military families with their money. Follow her on twitter @realKateHorrell.
  • SherryH

    I find this new co-pay policy disturbing in that all mail order scripts will have NO co-pay but medications you need immediately(i.e.) antibiotics will now be subject to a higher co-pay. I am not convinced that as a cost savings mechanism the amount of lost co-pays through mail order will be offset by an increased retail co-pay. Three thirty day prescriptions at the pharmacy nets a nine dollar co-pay from me but a ninety day supply from mail order nets zero dollars co-pay plus mail order has to pay the postage. Would be interesting to actually see cost projections and savings on this one. Additionally I like to see my pharmacist and be able to ask any pertinent questions or address any concerns I might have. If tis mail order is the thing of the future wonder how many jobs/pharmacies will be lost across the board.

  • Tom

    This program is good in theory but is a nightmare for doctors to send prescriptions too. My doctor refuses to deal with them because of the problems they have had with their fax system being unreliable and requiring multiple attempts to get through.

    There is and email system in place, but this too is more cumbersome than my doctor is willng to deal with.

    Until they can come up with a SIMPLE and easy way for doctors to interact with the system I will continue to get my prescriptions filled at the local pharmacy. The previous contractor for the program seemed to have it more together than Express Scripts.

    • I haven’t had a problem with anything. I went online and signed up then asked my Dr. to give me a written prescription which I filled in the required info on the back and mailed to Express Scripts.

      My only big problem is when I read on their form that for $21 the RX would be rush shipment that would go overnight delivery upon being filled. I assumed rush meant that they would fill it promptly only to find out the $21 was for overnight (they sent it on a Fri knowing that UPS does not deliver on Saturday. They also informed me that they still take the required 3-5 days to fill the RX so it took 8 days for me to get my Prescription which was one that I really was not suppose just stop. Not a happy camper and I would immagine that everyone there knows my name. I was irate.

  • They take FOREVER to send meds, screw up orders, have a complete lack of customer service, and when I registered multiple family members, there were such major glitches with the system, that I gave up. It once took me 20 days to receive my meds. As soon as I got them, it was time for a refill. Who can wait that long? I have meds that can’t be obtained at an MTF and they won’t order, and shouldn’t be exposed to the heat or cold. How does the mail fix this? This is a dangerous program because of delays and problems the shipping can cause to the medication’s efficacy. The military needs to reexamine their priorities.

    • Anja

      I absolutely agree, my one medication is also temperature sensitive and very expensive. One time it got lost in the mail and for a week they didn’t know where it was. NEVER AGAIN! Of course they wouldn’t exchange it either and send me the old stuff. I am done with ExpressScipt! They can keep they Great savings!

  • bdscared

    I’m scared to death of this mail order medications. One of my med’s alone keeps me walking, I can’t go with out it. Do we happen to know what country these medications are coming from? In my own personal pharmacy they had to switch distributer’s and the same med I had been taking for 6 months all of the sudden, made me very sick, puking, fever, chills, and shakes. To find out the new distributer was out of Mexico, and all the pharmacy could tell me they might put just a little bit more of the good stuff in it, just to let my body adjust. I want to know where my med’s come from, and to make sure I get the right stuff to make my body function properly!

  • Jeri

    Obama is hitting the military hard. First he takes back half of the COLA that retirees got two years ago, then now says that the COLA will probably go up to 3.4 percent. Guess he hasn’t been to the grocery store lately. My bill has more than doubled and we don’t eat or buy garbage. Now the co-pay is up by $2, making it now $5 per generic. This is a crime. We cannot sign up for the mail delivery as we travel throughout the US as work campers. I refilled a prescription today and that is how I found out as the military does not warn us. We have to search for it, and how would we know unless something happened? Walmart’s discounted price was only $4. So that means that the military will no longer pay for the generic prescriptions as long as you buy them at Walmart. More month for Obama to spend. This is getting sickening. Get this idiot out of office and take our country back or a revolution will ensue.

    • Mary

      This policy is actually a direct result of the Tea Party’s attempt to cut spending. Many conservative congressman don’t understand why we would deserve cheap healthcare. They have been very outspoken on the matter. It was all over the news post midterm election. No, I don’t agree with all of our president’s decisions, but let’s notice blame the man for every bad thing in our lives.

  • Marcelle

    Excellent point Margie.