The TRICARE For Life (TFL) Pharmacy Pilot has been underway for about two and a half months. Many Medicare eligible beneficiaries who have not yet moved their prescriptions to Home Delivery or a military pharmacy may soon have to pay the full cost of their medication if they fill their prescription a third time at a retail pharmacy. Congress created the TFL Pilot in the 2013 National Defense Authorization Act (NDAA).
The TFL Pharmacy Pilot requires TFL beneficiaries to move select maintenance medications (medications taken regularly for a chronic condition) to either TRICARE Pharmacy Home Delivery or a military pharmacy, or pay the full price when they fill them at a retail pharmacy. After the pilot started on March 15, 2014, beneficiaries get two “courtesy fills” at a retail pharmacy and each time received a letter notifying them of the pilot.
“We expect that many TFL beneficiaries have used their two courtesy fills at a retail pharmacy already,” said Dr. George Jones, Chief of the Defense Health Agency (DHA) Pharmacy Operations Division. “This means that if they fill their maintenance medications at retail again, they may have to pay the full cost of the medication out of pocket.”
Switching prescriptions from a retail pharmacy to Home Delivery can save beneficiaries as much as $152 a year for each prescription they move.
To switch a prescription to Home Delivery, beneficiaries can call Express Scripts, the TRICARE pharmacy contractor, at 1-877-882-3335. They can visit the Express Scripts website, www.express-scripts.com/TRICARE, ask their provider to electronically prescribe directly to “Express Scripts Mail Pharmacy” or mail in a registration form and hard copy of their prescription. Beneficiaries who want to use a military pharmacy should first call their local military pharmacy to make sure their prescription is available.
“Our primary goal is to deliver a sustainable benefit, comply with the NDAA and implement the TFL Pilot as smoothly for beneficiaries as possible,” said Dr. Jones. “We are working closely with Express Scripts to educate affected beneficiaries and make sure they have all the information they need to participate in the Pilot.”
For more details on the TFL Pharmacy Pilot, please visit www.tricare.mil/tflpilot