TRICARE Beneficiaries Save on Prescription Delivery, Vaccines
By Terri Moon Cronk
American Forces Press Service
WASHINGTON, Aug. 30, 2011 Beneficiaries of the TRICARE military health plan can obtain 90 days of home-delivered medication with no copayment and can get free vaccinations at participating pharmacies without seeing a doctor.
These measures can make life a bit simpler for beneficiaries of the military health plan, Navy Rear Adm. (Dr.) Christine Hunter, TRICARE Management Activity’s deputy director, said in an Aug. 26 interview.
"We're trying to encourage people to use TRICARE's home delivery for a 90-day supply of generic medication, because by Oct. 1, there will be no copay," she said.
Many people get their prescriptions filled at military treatment facilities, which remains "our preferred place for people to go," Hunter said. No changes exist in the cost of prescriptions from military hospital pharmacies, she said. Some 70 percent of TRICARE beneficiaries obtain generic medications, and those kinds of medications will be home-delivered in a 90-day supply at no copayment, Hunter said.
For beneficiaries who use TRICARE pharmacies, however, the retail cost of generic medications will increase from $3 to $5 for a 30-day supply, Hunter said, and brand-name medications will increase from $9 to $12 for a 30-day supply.
According to TRICARE’s website, DOD established a uniform list of covered brand-name and generic drugs, as well as a third tier of drugs designated as “non-formulary.” Prescriptions for non-formulary medications can be dispensed, but at higher cost to beneficiaries, unless the provider can establish medical necessity.
Hunter said a one-month supply of a non-formulary medication will cost $25 at a TRICARE pharmacy. "So, it's always better to use TRICARE home delivery for any chronic medications," she said.
Hunter suggested that people use home delivery "when they know they can tolerate a new medication, know they're going to be on it awhile, or it's something they’ve been taking."
The home delivery plan saves time and money for beneficiaries, and the government also benefits from the savings, Hunter noted.
"When you get your medications through TRICARE home delivery, the government gets a volume discount,” she explained. “And it's cheaper for our beneficiaries, because they get a 90-day supply for zero copay."
TRICARE’s mail orders for prescriptions grew by about 10 percent in 2010, the admiral said. At the same time, she added, retail growth decreased about 3.9 percent, producing a medication savings of $30 million, and people received their medications more conveniently at home.
In addition to prescription home-delivery savings, Hunter said, TRICARE offers beneficiaries seasonal flu shots, school vaccinations and other immunizations.
Beneficiaries can get most of their vaccinations from participating TRICARE pharmacies, eliminating the need to schedule clinic appointments, Hunter said.
"It’s also a great time to update your family [vaccine] checklist so you keep everyone healthy," Hunter said.
Many schools require an update on vaccines and immunizations before children return to school, she noted. Parents typically look at a tetanus booster and other immunizations for their children, she said, and the meningococcal vaccine for children going off to college. People who plan to travel might consider a hepatitis vaccine, she added.
"Flu shots are recommended for just about everybody these days, and are available at our TRICARE pharmacies," Hunter said. "But what people might not know is the pertussis [whooping cough] vaccine is recommended for more and more adults, especially for those with small children."
In the past year or so, Hunter and her staff began to make a limited number of vaccines available at TRICARE pharmacies for flu shots, the influenza A [subtype H1N1] virus, and the pneumonia vaccine. TRICARE provided 300,000 vaccines that first year, she said, and the program has expanded to all immunizations normally covered under the TRICARE preventive medicine benefit with no copayment.
Some limitations exist, Hunter noted. Pharmacy participation varies, some facilities stock only certain vaccines, and some don’t immunize children. Others provide vaccinations only on certain days and times, she explained.
"Call ahead to make sure they have the vaccine, and if someone's there to give it," Hunter said. "There is no copay. It is part of TRICARE’s preventive care, and we want people to be able to get it conveniently and easily."
The admiral also suggested going to TRICARE’s website to find participating pharmacies by area.