Raising military pharmacy copays by 100% to 400%, as recommended in the FY2009 Defense budget proposal would put military pharmacy benefits among the lower half of civilian plans, according to the HayGroup 2007 Benefits Prevalence Report.
For generic drugs purchased in retail pharmacies, the defense budget proposes raising the beneficiary copay from $3 to $15. According to HayGroup, 83% of civilian employer plans charge less than that for generic drugs, with almost 20% charging $5 or less.
For brand-name drugs in retail stores, the Pentagon proposes raising the TRICARE copay from $9 to $25. The HayGroup survey indicates that almost half of civilian employers (45%) charge less than that.
For brand-name, non-formulary medications, the TRICARE copay would rise from $22 to $45 -- more than 68% of civilian plans charge. This chart shows the percentage of civilian retail pharmacy plans that offer lower copays for medications. It distinguishes between the current copay structure and the DoD proposal for FY09.
In fact, many civilian plans are reducing or eliminating copays for generic drugs and medications used to treat chronic diseases like diabetes, because studies have found that higher copays actually deter many patients from taking medications that reduce the need for much higher-cost procedures later in life.
For one data point, MOAA's own employee plan (BlueCross BlueShield) offers our employees retail medications for copays of $10 (generic), $20 (brand) and $35 (non-formulary brand) -- lower across the board than proposed for military beneficiaries. The TRICARE copays also would exceed those offered under many plans available to legislators and federal civilians.
Most telling of all, Wal-Mart offers over 360 medications at a copayment of only $4 to anyone who walks in the door.
Perhaps the purpose of the Pentagon-proposed fee hikes is to push more beneficiaries to use Wal-Mart rather than their TRICARE benefit.
That would certainly save the Defense Department money. But it wouldn't make military people feel very good about their military health coverage.
MOAA believes military beneficiaries' extraordinary service and sacrifice have earned them the best health coverage in America, and that it's an insult to propose shifting them to second-tier pharmacy coverage.
