MOAA Urges Congress to Temporarily Waive TRICARE Mail Order Copays

MOAA Urges Congress to Temporarily Waive TRICARE Mail Order Copays
An Air Force pharmacy technician displays proper protective gear while manning the desk March 23 at a pharmacy on Goodfellow AFB, Texas. (Photo by Airman 1st Class Abbey Rieves/Air Force)

Note from MOAA: Have you been impacted by the coronavirus pandemic, or the response? Share your story to help MOAA understand the needs of the uniformed services community in this challenging time.

 

With additional legislation to address the coronavirus pandemic potentially in the works, MOAA is urging congressional leaders to temporarily waive TRICARE mail order pharmacy copays.

 

TRICARE pharmacy copays were set into law with the FY 2018 National Defense Authorization Act. For calendar year 2020, the mail order copay for a 90-day supply of medications is $10 for generics, $29 for brand name, and $60 for non-formulary drugs.

 

[TAKE ACTION: Ask Your Lawmakers to Waive Mail Order Copays During the Pandemic]

 

Many military families — particularly those with special needs, wounded warriors, and Medicare-eligible retirees and their spouses — take multiple maintenance medications each day.

 

Even with the COVID-19 national emergency, the Defense Health Agency (DHA) does not have the authority to modify TRICARE pharmacy copays, so MOAA is advocating for a legislative fix.

 

[RELATED: Read This Pentagon-Produced FAQ on Pharmacy Operations During the COVID-19 Pandemic]

 

Military families appreciate the option of getting medications at no cost from pharmacies at military treatment facilities (MTFs), since TRICARE mail order copays can quickly add up. The TRICARE pharmacy copay structure creates a strong incentive for patients to visit the MTF pharmacy, increasing risk of exposure to COVID-19.

 

Eliminating mail order copays reduces the financial incentive to use MTF pharmacies and encourages social distancing during the coronavirus pandemic, a precaution that is strongly recommended by the Centers for Disease Control and Prevention.

 

A copay waiver is particularly important since some installations have instituted temporary access restrictions while others have put limitations on pharmacy access intended to protect both patients and health care teams, with more restrictions likely should conditions worsen.

 

[LATEST NEWS AND GUIDANCE: MOAA.org/Coronavirus]

 

MOAA seeks to ensure impacted families don’t face sudden, unexpected out-of-pocket costs related to medication copays.

 

Please consult the TRICARE website for guidance on transferring your prescriptions to mail order or retail. If you experience problems transferring your prescriptions, please let us know at legis@moaa.org or by sharing your story.

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About the Author

Karen Ruedisueli
Karen Ruedisueli

Ruedisueli is MOAA’s director of government relations for health affairs and also serves as co-chair of The Military Coalition’s (TMC) Health Care Committee. She spent six years with the National Military Family Association, advocating for families of the uniformed services with a focus on health care and military caregivers.