washingtonscene
substantially reduced the DoD-proposed copayment increases for FY 2013; put a statutory cap on any increases after FY 2013, so the percentage increase in phar- macy copayments in any year couldn’t ex- ceed the retired pay COLA percentage; and to pay for these, established a five-year pilot program that would require TFL beneficiaries to use the mail-order system for at least one year to refill any main- tenance medications (waivers would be allowed under certain hardship or other conditions); after one year, beneficiaries could opt out of mail-order participation. What copayment reductions would the
House plan buy with the mail-order offset? The chart below contrasts how copay- ments would change over the next five
years under the House proposal versus the DoD/Senate plan. Compared to the DoD/Senate plan, the
House-passed plan would: cut retail copayments by about 40 per- cent below the DoD plan; keep access to non-formulary medica- tions in retail stores; cut mail-order copayments by more than 50 percent for brand-name medications; Cut mail-order copayments by 25 per- cent for non-formulary medications; and keep mail-order copayments at zero for generic medications. Without the House-proposed statutory cap on future increases, we’ll be held hos- tage to bigger copayment increase propos- als every year. But if the COLA-based cap
DoD/Senate vs. House-Passed Pharmacy Copayments
The table shows the differences over the next five years between the House plan and the DoD/Senate proposal for TRICARE pharmacy copayment increases.
Retail
Generic DoD/Senate House
Brand name DoD/Senate House
Non-formulary DoD/Senate House
Mail Order
Generic DoD/Senate House
Brand name DoD/Senate House
Non-formulary DoD/Senate House
FY 2012 FY 2013 FY 2014* FY 2015* FY 2016* FY 2017* $5
$5 $5
$12
$26 $17
$25 ** $44 ** $45.32 ** $46.68 ** $48.08 ** $49.52
FY 2012 FY 2013 FY 2014* FY 2015* FY 2016* FY 2017* $0
$0 $0
$9
$26 $13
$25
$51 $43
*Assumes 3-percent annual COLAs **Non-formulary medications wouldn’t be available in retail pharmacies under the DoD/Senate plan $54 $44.29 $58 $45.62 $62 $46.99 $66 $48.40 $28 $13.39 $30 $13.79 $32 $14.20 $34 $14.63
$0 $0
$0 $0
$0 $0
$9 $0
$28 $17.51 $30 $18.04 $32 $18.58 $34 $19.14 $6 $5.15 $7 $5.30 $8 $5.46 $9 $5.62
34 MILITARY OFFICER AUGUST 2012
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96