Why MOAA’s Fight to Maintain TRICARE Pharmacy Access Matters to You

Why MOAA’s Fight to Maintain TRICARE Pharmacy Access Matters to You
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The wife of a MOAA member from Clarksville, Ark., needed a prescription to treat an illness shortly before Thanksgiving – an immediate need that couldn’t wait for mail-order fulfillment.


In 2021, the member had three pharmacy choices near his residence – two independent locations and a Walmart. Now, only one independent remains in the TRICARE pharmacy network … and it will leave in January, he told MOAA. Starting in 2024, TRICARE beneficiaries in the area with acute medication needs will face a 60-mile, 90-minute round trip, sometimes traveling on winding roads that can be hazardous in foul weather.


While most healthy families in metro areas will have access to a nearby TRICARE network pharmacy despite a 24% cut in the brick-and-mortar network since 2022, these reductions have had a disproportionate impact on rural families and those with more complex medical needs.


[SHARE YOUR STORY: Impact of TRICARE Pharmacy Network Changes]


MOAA appreciates that the Senate report for the FY 2024 National Defense Authorization Act (NDAA) directs the Government Accountability Office (GAO) to conduct an assessment of the network. GAO will provide an independent review of network cuts, including an assessment of access issues for those in remote or rural areas, long-term care pharmacies, and beneficiaries with cancer diagnoses or rare and complex conditions.


MOAA took this issue to Capitol Hill early this year as NDAA discussions began. The smaller network had just gone into effect and lawmakers and professional staff members wanted additional data to evaluate the change, so MOAA advocated for a report on beneficiary impact.


Reduced retail pharmacy network requirements in the new TRICARE pharmacy contract, known as TPharm5, slashed the minimum number of retail network pharmacies from 50,000 to 35,000 as a cost-cutting measure. Independent pharmacies fled the TRICARE network after being offered contracts with reimbursements that would not even cover their costs.


After this network cut was announced, MOAA heard from hundreds of military families about potential impacts. Many of these families already use the TRICARE mail-order program for maintenance medications but were concerned about how the narrowed network would create barriers to getting acute medications most often needed due to illness or injury.


[RELATED: MOAA Named to The Hill’s Top Lobbyist List for 17th Straight Year]


There are approximately 66,000 retail pharmacies in the U.S. Less than a year ago, there was an 83% chance a beneficiary’s pharmacy would be in the network. That’s now 64%, and it could drop to 53% based on minimum contract requirements.


What These Cuts Could Mean for You

As MOAA outlined in our annual TRICARE Guide, not having network pharmacy options may not matter for you now, but it could if (or when) you fall into one of these groups in the coming years:

  • Seniors: Limited transportation options and other challenges can significantly reduce comfortable travel distances.
  • Rural residents: A smaller network means fewer options, if any remain, in your county.
  • Care restrictions: You may no longer have access to the pharmacy in your hospital’s lobby, or to the only pharmacy used by your future assisted living or long-term care facility.
  • Immediate needs: Finding medication during a shortage, or tracking down an uncommon prescription, becomes much more difficult with a smaller network.


[READ MORE: Pharmacy Network Cuts: Will You Get What You Need?]


MOAA appreciates our Clarksville member taking the time to share his story, despite the demands of caring for his wife during her illness and shifting their Thanksgiving plans to Marie Callender turkey dinners “spiked up with a can of Ocean Spray cranberry sauce.” Stories like these augment the data and show lawmakers how TRICARE benefit decisions impact real lives.


Have you encountered a shrinking pharmacy network in your area? Have you encountered challenges getting TRICARE-covered prescription medications for a loved one in long-term care? Faced drugs shortages that forced you to fill a prescription at a non-network pharmacy? Please share your stories with MOAA so we can take them to Capitol Hill and illustrate how pharmacy network cuts hurt TRICARE families.



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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.