washingtonscene TRICARE Mail- T

Order Mandate How beneficiaries get their medicine is about to change.

RICARE beneficiaries will be required to refill select mainte- nance medications* through TRI-

CARE Pharmacy Home Delivery or at a military pharmacy — or pay the full retail price — beginning Oct. 1. This provision originally was tested

through a pilot program from the FY 13 Defense Authorization Act, which man- dated TRICARE For Life beneficiaries into the above requirements. The FY 2015 Defense Authorization

Act expanded the pilot program to encom- pass all TRICARE beneficiaries, with the exception of those on active duty, those with other health insurance that provides drug coverage, or those who live overseas. While active duty servicemembers are ex- empt from the mandate, active duty family members will be required to participate in the program. In September, beneficiaries should have

received a notification letter from TRI- CARE providing enrollment instructions and details on the waiver process. Beneficiaries still can get short-term

or “acute” drugs, like antibiotics and pain medications, from retail pharmacies. The new mandate only applies to select main- tenance medications, many of which are brand-name. Unlike with the pilot, beneficiaries can- not opt out of the program after one year. Starting Oct. 1, beneficiaries will have

approximately 90 days to move their pre- scriptions before being responsible for 100 percent of the cost share. MOAA long has said home delivery is a low-cost, safe, and convenient option

for beneficiaries to fill their maintenance medications and save money. “Switching to TRICARE’s home de-

livery saves the government, on average, 32 percent on brand-name drugs filled through the mail order,” says Capt. Kathy Beasley, USN (Ret), a MOAA deputy direc- tor of Government Relations. “However, beneficiaries do lose the retail pharmacy choice for maintenance medications.”

TRICARE W

Funding at Risk Deadline looms as funding nears exhaustion.

eeks after the VA asked Congress for a bailout, DoD has come forward with its own

$2 billion budget crisis. Without help, DoD could run out of health care funding for outside treatment. However, unlike the VA, DoD not only is looking at Congress to bail it out but also for beneficiaries to take on even more costs. DoD was forced to request additional funding to cover a budget shortfall be- cause of the rising costs of compound medications. DoD revised its compound medication policy in May to curb costs, but the budget shortfall remains. In its request, DoD says it is trying

to control costs, pointing to its payment reform initiatives. Missing from the nar- rative, however, are the beneficiary ini- tiatives that have resulted in significant cost savings. Over the past several years, TRICARE beneficiaries have been forced to ac- cept several health care fee increases and policy changes. Specifically, annual pharmacy copayment increases and man- dated use of the

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*more details: Review the select drug list at www.health.mil/selectdruglist or call Express Scripts at (877) 363-1303. 34 MILITARY OFFICER OCTOBER 2015