Attention Military Retirees: TRICARE for Life Pharmacy Pilot Starts Soon
The TRICARE for Life (TFL) Pharmacy Pilot will start in mid-February. The pilot requires TFL beneficiaries who fill prescriptions for maintenance drugs at a retail pharmacy to switch to either home delivery or a military treatment facility (MTF) pharmacy. If you are affected by the pilot, you will receive a letter from Express Scripts.
Who is affected by the TFL Pharmacy Pilot?
TFL beneficiaries who use a retail pharmacy to fill a brand name maintenance drug prescription are included in the pilot.
- A retail pharmacy is any pharmacy that is not part of a hospital or MTF. They include large drugstore chains such as CVS and Rite Aid, neighborhood “mom & pop” pharmacies, and pharmacies located in grocery or mass merchandise stores such as Safeway, Walmart, or Target.
- A maintenance drug is any prescription you take regularly. You can view the list of maintenance drugs included in the pilot online.
Once the pilot starts, these prescriptions must be switched to home delivery or a MTF.
Who is NOT affected by the TFL Pharmacy Pilot?
Please note that you may not be required to participate in the pilot if you use a generic drug for your maintenance medication. Generally, prescriptions for generic maintenance drugs can still be filled at a retail pharmacy for only $5.
Antibiotics, or other drugs you take for short time, are also not included in the pilot. TFL beneficiaries can still fill short term prescriptions at a retail pharmacy.
TFL beneficiaries who already fill their maintenance prescriptions at an MTF are not affected by the pilot. You will still be able to get your maintenance medications for free at your MTF, assuming they stock the drug you are prescribed.
How will I be notified if I am affected by the TFL Pharmacy Pilot?
Express Scripts is mailing letters to all affected TFL beneficiaries on February 18. The letter will include details on your options for switching to home delivery including online, calling the customer service line, mailing a registration form, or asking your medical provider for assistance.
Do I have any options other than home delivery if I am affected by the pilot?
If you are near an MTF, you might consider filling your maintenance prescriptions there for free. Please be aware that military pharmacies don’t stock all drugs that TRICARE covers, so your prescription may not be available. If you are thinking about switching to an MTF, phone first to see if they carry your medication and ask how to transfer the prescription.
What happens if I accidentally fill a brand name maintenance prescription at a retail pharmacy after the pilot starts?
TRICARE allows two courtesy refills after the pilot starts:
- The first time you fill one of the selected maintenance medications at a retail pharmacy, TRICARE will cover the prescription, but you will get a second letter from Express Scripts reminding you to switch to home delivery.
- The second time you fill the maintenance prescription at a retail pharmacy, TRICARE will again cover the prescription, but you will get a third reminder letter.
- If you make a third attempt to fill the prescription at a retail pharmacy, TRICARE will no longer cover the prescription. You will be responsible for 100% of the cost of that maintenance drug when filling it at a retail pharmacy.
To get more information or to sign up for email updates on the TFL Pharmacy Pilot, visit TRICARE’s website. Look for the blue box on the right side of the page to sign up for email updates.
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