Pharmacy Copayments to Increase

Now that the National Defense Authorization Act for Fiscal Year 2013 has been signed into law by President Barack Obama, TRICARE Management Activity (TMA) will be increasing TRICARE beneficiaries’ pharmacy copayments. According to TMA, this change “will be effective sometime in February.” Here are the changes: 

  • NO increase to copayments for medications filled at a Military Treatment Facility 
  • NO increase in copayments for active duty service members 
  • NO increase in copayments for generic medications. TRICARE Home Delivery remains at $0 and retail network copayment stays at $5 
  • New copayment for formulary medications (Tier 2) filled: 
    • At a retail network pharmacy will be $17 , an increase from $12 for a 30-day supply 
    • Through TRICARE Home Delivery will be $13, and increase from $9 for a 90-day supply
  • New copayments for non-formulary medications (Tier 3) filled: 
    • At retail network pharmacy will be $44, an increase from $25 for a 30-day supply 
    • Through TRICARE Home Delivery will be $43, an increase from $25 for a 90-day supply

Starting in 2014 and beyond, copayment increases (if any) will be by the same percentage as retiree cost-of-living adjustments (COLA). In years when COLA increases would total less than a dollar, it will be delayed a year and combined with the next adjustment until it reaches a $1. Therefore, increases will always be $1 or more.

(Source: http://tricare.mil/CoveredServices/BenefitUpdates/Archives/PharmacyCopayChanges.aspx)

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