Weekly Volcano Blogs: Walkie Talkie Blog

March 6, 2014 at 2:33pm

Madigan Army Medical Center helps TRICARE For Life beneficiaries move to pharmacy pilot program

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For one group of TRICARE beneficiaries, life is getting a little easier and a little more affordable ... and they won't even have to wait in line at Madigan Army Medical Center.

A new pilot program will require TRICARE For Life (TFL) beneficiaries to use the TRICARE Pharmacy Home Delivery or a Military Treatment Facility (MTF) pharmacy to fill prescriptions for select maintenance medications.

The pilot, which will begin March 14, will conclude in Dec. 2017, at which time the determination of whether to make it a permanent program or not will be made. However, after the end of the first year of the pilot, beneficiaries can choose to opt out of the program.

According to Col. Donald Goode, Madigan's pharmacy chief, the Department of Defense has estimated close to 500,000 beneficiaries will be impacted by the TFL change. TFL offers secondary coverage to Medicare for all TRICARE beneficiaries who are older than 65 and eligible to Medicare Parts A and B.

TFL beneficiaries taking an affected medication were first notified in mid-February. Beneficiaries are permitted to obtain two 30-day refills of their prescriptions at a retail pharmacy for the same co-pay they've been paying; following that, the costs at retail pharmacies will be 100 percent with no co-pay.

Some individuals are exempt, including people with another prescription drug plan or people living outside the 50 United States. Furthermore, TFR beneficiaries living in a nursing home may contact Express Scripts to request a waiver.

While the formulary at an MTF is going to be limited to what medications physicians onsite use, the home delivery formulary is far more extensive. TRF beneficiaries who wish to switch existing prescriptions to the Madigan pharmacy can call 253.968.2999 to check on availability and arrange for transfers.

Switching to TRICARE's mail order pharmacy, Express Scripts, is also simple. Beneficiaries can enroll and transfer prescriptions online, by phone or by mail. Through home delivery, beneficiaries can receive a 90-day supply of their brand name medication for $13, while generic versions are available at even lower prices. 

"I wholeheartedly believe in and support the mail-order pharmacy service, especially for maintenance medications for chronic health problems," Goode said. "This could potentially increase patients' compliance with medication and treatment, because it makes obtaining the medications so much easier and they are less likely to run out."

Goode recommended that individuals transferring into the Express Scripts program get two prescriptions from their providers - one for acute care that can be filled immediately and then a 90-day prescription (with three refills) that can be obtained through the mail-order program.

For the most recent information about the pilot, go to www.tricare.mil/tflpilot. TRICARE beneficiaries can also contact Express Scripts directly at 877.882.3335 or www.express-scripts.com/TRICARE/TRICAREForLife/.

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