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Prescriptions -- Question & Answer Listing  
Viewing 1-6 of 6 Knowledge Entries
Question / Answer

Question:
How do formularies impact prescription costs and availability within the defense health system?

Answer:
Military Treatment Facilities are required to stock a DoD specified list of medications. It is DoD’s policy to substitute generic medications for brand-name medications when available to minimize pharmaceutical costs. However, brand-name drugs that have a generic equivalent may be dispensed if the prescribing physician is able to justify medical necessity for its use over the generic equivalent. Co-payments for brand-name prescription drugs obtained through retail pharmacies covered by TRICARE are higher than those for generic prescription drugs.

Question:
How do I refill prescriptions through the military medical system?

Answer:
There are three ways to have prescriptions refilled through the military medical system. You can refill them online, by phone or by mail. You will need to know your member number (sponsor's Social Security Number); your prescription or Rx number, and your credit card information to cover any co-payments that apply. Contact your regional TRICARE contractor for more information on the pharmacy program.

Question:
What are the benefits of, and eligibility requirements for, the TRICARE Senior Pharmacy Program?

Answer:
The TRICARE Senior Pharmacy Program authorizes uniformed services beneficiaries 65 years of age and over to obtain low-cost prescription medications from the TRICARE Mail Order Pharmacy (TMOP) and TRICARE network and non-network civilian pharmacies. Beneficiaries may also continue to use military hospital and clinic pharmacies where there are no charges for available prescriptions.

Question:
What is the TRICARE Mail Order Pharmacy Program?

Answer:
The TRICARE Mail Order Pharmacy (TMOP) Program allows TRICARE beneficiaries the opportunity to order prescriptions online and receive them via mail. The TMOP is generally used for prescription medications taken for long-term, ongoing conditions (such as blood pressure medication or insulin for diabetics). Active duty beneficiaries worldwide (including Reserve/National Guard personnel and their family members on Title 10 or Title 32 (federal) active duty orders for more than 30 days), TRICARE-eligible beneficiaries (all ages), and Continued Health Care Benefit Program Enrollees are eligible to use the TMOP as long as they are enrolled the Defense Enrollment Eligibility Reporting System (DEERS). There are some restrictions such as beneficiaries who are over 65 and enrolled in Medicare Part B and for individuals who are covered by other health insurance with a pharmacy benefit. Additionally, co-payments apply for all, except Active Duty (AD) personnel.

Question:
What is the TRICARE Retail Pharmacy (TRRx) Program?

Answer:
The TRICARE Retail Pharmacy (TRRx) Program is a retail pharmacy services that, until June of 2004, were provided through various TRICARE regional managed care support contractors.  Currently, it is managed under a single contract that now integrates the previous regional pharmacy contract which makes the claims process easier because it is centralized. The new TRRx pharmacies are located in nationwide across the United States including the District of Columbia, and in the territories of Puerto Rico, the U.S. Virgin Islands and Guam.  To locate a network pharmacy, beneficiaries may use the TRICARE pharmacy locator service available on the Express Scripts Web site at www.express-scripts.com/TRICARE, or call (866) 363-8779, which using the letters on the telephone keypad spells (866) DoD-TRRx. For beneficiaries who travel the TRRx benefit is now portable. which means that TRICARE Prime beneficiaries traveling outside of their designated TRICARE region who need to fill a prescription are no longer required to pay the full prescription price or file a TRICARE claim to get reimbursed for their out-of-pocket expenses as long as they use the TRRx network.

Question:
What is TRICARE's policy on prescriptions, including individual co-pay?

Answer:
Eligible beneficiaries may fill prescription medications at military treatment facility (MTF) pharmacies (at no charge for available prescriptions); through the TRICARE Mail Order Pharmacy (TMOP); at retail network pharmacies; and at non-network pharmacies. The TMOP and retail network pharmacies require co-pays. Non-network pharmacies require you to pay for the prescription up front and then file a claim for partial reimbursement.
Viewing 1-6 of 6 Knowledge Entries

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