TRICARE for Life Pharmacy Pilot Details

Earlier this year, we shared information about the TRICARE for Life (TFL) Pharmacy Pilot. The pilot began in mid-March and 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. TFL beneficiaries affected by the pilot were notified by Express Scripts in February.

We spoke with Express Scripts and received answers to some of YOUR questions.

How will Express Scripts handle beneficiary questions about the pilot?

Express Scripts has established a dedicated phone line (877.882.3335) to help beneficiaries convert their prescriptions to mail order and/or to answer questions. Beneficiaries can also call the regular customer service line (877.363.1303) with questions.

What happens if I start taking a new maintenance medication after the pilot starts?

If you remember, you can ask your doctor to submit the new prescription directly to Express Scripts. Otherwise, if you fill a new maintenance prescription at a retail pharmacy, it will count as one of your two courtesy refills that each beneficiary gets for each prescription. Filling a maintenance medication prescription at a retail pharmacy will cause Express Scripts to send a series of communications (phone call, letter, email if possible) with instructions for using the mail order system.

What if my doctor needs to adjust my maintenance medication?

If the doctor is trying something on a temporary basis (adjusting a dosage, for instance), you can fill that short term prescription at a retail pharmacy just like you would fill a short term prescription for antibiotics, for instance.

What if I’m traveling when my mail order refill is due to arrive?

If your travel plans conflict with your refill’s scheduled arrival, you have a few options. 

  • You can contact Express Scripts customer service and arrange to have your refill arrive early, before you depart for your trip.
  • Or, you can request that Express Scripts send your refill to your travel destination. If those options don’t seem feasible, you can request a waiver.

Can beneficiaries opt out of the pilot after one year?

Yes. Beneficiaries are allowed to opt out any time after the first year. That year is counted from the first time they use the mail order refill system.

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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