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MOAA Urges TRICARE to Waive Early Medication Refill Limits

MOAA Urges TRICARE to Waive Early Medication Refill Limits
Photo by Staff Sgt. Liliana Moreno/Air Force

With the COVID-19 situation rapidly evolving, MOAA members are understandably concerned about TRICARE coverage related to the virus. MOAA has reached out to TRICARE officials urging them to enhance communication with beneficiaries and reconsider TRICARE’s prescription refill policy in light of guidance from the Centers for Disease Control and Prevention (CDC) and policy updates by Medicare and commercial plans allowing early prescription refills.

 

To sign up for TRICARE coronavirus email updates, please visit the TRICARE website

 

[RELATED: News and Links at MOAA.org/Coronavirus]

 

Current CDC guidance recommends people at high risk for COVID-19 complications — older adults, those with underlying medical conditions — prepare for an extended stay at home to avoid getting sick if an outbreak happens in their community. Recommended preparations include having a supply of medications on hand or switching to mail order prescription delivery.

 

MOAA has talked to the Defense Health Agency (DHA), and officials there are encouraging beneficiaries to use TRICARE’s Express Scripts mail order program. While we agree home delivery is a good option for many, it is not sufficient to address all beneficiary concerns.

 

DHA must also ensure refill limits for 30-day maintenance medications filled at retail pharmacies, such as Walgreens, allow beneficiaries who must or prefer to use retail pharmacies to maintain an adequate supply of prescription drugs given the circumstances.

 

If you currently fill 30-day supplies of your medication at a local pharmacy and would like a longer-term supply, you have two options:

  • Ask your physician to write your prescription for a 90-day supply and fill it using Express Scripts Home Delivery. Standard TRICARE mail order refill policies allow you to refill or renew a prescription medication after two-thirds of the timeframe for your prescription has passed. This means you can refill a 90-day prescription after 60 days (when you have a 30-day supply remaining.)
  • Fill three 30-day supplies at a retail pharmacy at one time (three copays will apply). We are still trying to verify refill timing policy if you use this option.

 

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We have also asked for clarification on TRICARE referral and authorization requirements and cost shares for diagnostic tests related to COVID-19 as well as guidance on military treatment pharmacy refill policies.

 

Please keep in mind, the Military Health System Nurse Advice Line is available 24/7 by phone (1-800-TRICARE, option 1), web chat, and video chat to all TRICARE beneficiaries except those enrolled in the U.S. Family Health Plan (USFHP).

 

Because the Nurse Advice Line is currently experiencing high call volumes, beneficiaries who get care from civilian providers in the community should contact their provider first if they have any questions or concerns.

 

USFHP beneficiaries should check their plan website for nurse chat and telehealth options.

Coronavirus Resources

Please see below for the full TRICARE statement related to pharmacy coverage:

 

 

COVID-19 - TRICARE Pharmacy Statement:

 

The TRICARE pharmacy benefit is built to take care of our service members, veterans, retirees and their families with flexible options to meet beneficiary needs. We deliver the pharmacy benefit through multiple points of service, to include offering the opportunity to limit exposure to the public by employing our safe and convenient home delivery option for maintenance medications (drugs taken for long term conditions).

 

The Centers for Disease Control and Prevention (CDC) COVID-19 guidance includes the recommendation to have a supply of necessary medications on hand. TRICARE offers beneficiaries the option to get a 90-day supply of their prescriptions at military pharmacies, via TRICARE Pharmacy Home Delivery, or at retail network pharmacies.

 

As a first step, beneficiaries should ensure they have refills remaining on their prescription. Each prescription bottle indicates the number of refills remaining. If there are no refills left, they will need to call their healthcare provider. If enough refills remain, beneficiaries can get a 90-day supply at military pharmacies, via TRICARE Pharmacy Home Delivery, or at retail network pharmacies.

 

Military pharmacies offer a 90-day supply of medications at no cost to beneficiaries. After military pharmacies, home delivery is the most affordable option. Beneficiaries can switch to home delivery to get a 90-day supply delivered right to their door. At a retail network pharmacy, beneficiaries can get up to three, 30-day supplies (three copays will apply).

 

Home delivery provides a convenient and affordable way to get medications without leaving the house. There are many convenient ways to switch a prescription to home delivery to include by phone, online, and via the Express Scripts mobile app.

 

Currently there are no pharmacy supply chain issues/outages as a result of COVID-19 and the Defense Logistics Agency is engaged with Prime Vendors to ensure Military pharmacies get their fair share if shortages do occur.

 

How to Switch to TRICARE Pharmacy Home Delivery

  • Military Pharmacy: Ask your military pharmacist to transfer your prescription to home delivery.
  • Phone: Call 1-877-363-1303 and have your prescription bottle ready.
  • Mobile app: If you have an existing prescription at a retail or military pharmacy, you can transfer it to delivery using the Express Scripts mobile app.
  • Online: Visit https://militaryrx.express-scripts.com/home-delivery.
  • e-Prescribe: Ask your doctor to submit your prescription electronically (e-Prescribe).
  • Mail: Download and fill out the Home Delivery Order Form at https://militaryrx.express-scripts.com/home-delivery and then mail the form and your 90-day prescription to the address listed on the form.
  • If you have other health insurance with a pharmacy benefit, you can't use home delivery unless your prescription isn’t covered by your other plan, or you've reached the dollar limit of your other plan. Home delivery is not available in Germany.

 

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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.