Tricare for Life pharmacy pilot begins in March

Beneficiaries of Tricare for Life soon will be getting letters notifying them of a new pharmacy pilot program.

The letter will direct beneficiaries to a pilot program that requires them to get certain medications through home delivery or at a military pharmacy. Officials said the congressionally mandated pilot program, which starts March 15, applies to refills of maintenance medications that are taken regularly for chronic conditions.

Tricare for Life provides secondary coverage for U.S. beneficiaries who have both Medicare Parts A and B.

Under the pilot program, Tricare will stop paying for these medications when filled from a retail pharmacy. The program does not apply to medications that are taken for a limited time to treat acute conditions—including items such as antibiotics and pain medications. Nor does the pilot apply to generic drugs at this time, according to officials.

After being notified if they are taking a medication covered under the program, beneficiaries will be able to get two “courtesy refills” at a retail pharmacy before they either switch to home delivery or assume the entire cost of that medication. Beneficiaries using home delivery get a 90-day supply of brand-name medications for $13, and of generic drugs with no co-pay.

The pilot program is required under the 2013 National Defense Authorization Act. While the pilot will go on for five years, beneficiaries can opt out after filling an affected prescription through home delivery for one year.