Written and medically reviewed by Dorcas Morak, Pharm.D
Do you wonder how customers of independent pharmacies will be affected by the news that about 15,000 independent pharmacies departed the TRICARE retail pharmacy network starting October 24? This new move could leave patients, especially in rural areas with few options to get their prescriptions filled.
Although roughly 15,000 pharmacies are no longer part of the network, access to about 41,000 pharmacies will still be available, according to Edward Norton Jr., Chief of the Pharmacy Operations Division at the Defense Health Agency. Continue reading to learn about the impact and actions that affected beneficiaries should take.
Why did about 15,000 Pharmacies Leave TRICARE In-Network?
Over 27% of the in-network TRICARE pharmacies are no longer a member of the TRICARE military health benefits network due to a decrease in reimbursement rates by the company that manages the TRICARE Pharmacy system, Express Scripts.
How Accessible are the Remaining In-Network TRICARE Pharmacies?
Despite removing approximately 15,000 pharmacies, over 90% of the beneficiaries will still have at least one in-network pharmacy within 15 minutes drive from their home. Tricare retail pharmacy network includes:
- Chain pharmacies
- Independent neighborhood pharmacies
- Grocery stores
- Wholesale warehouse stores
How can I Find Participating Pharmacies near me?
The list of participating pharmacies near you is contained in the letter sent to the affected people in mid-September. You can also find the pharmacy near you with this resource.
What should I do if I have a Prescription in one of the Pharmacies that Left the TRICARE In-Network?
If you have a prescription in one of the pharmacies that left the TRICARE in-network, you can transfer it any of these ways:
- Contact another participating in-network pharmacy and show them your medicine bottle. The pharmacy will guide you on what you should do.
- Inform your doctor’s office about the changes and ask them to send your prescription to your new in-network pharmacy.
- Call your new in-network pharmacy and request they initiate the transfer of your prescription.
What will happen if I fill a Prescription at a Pharmacy that is not in the TRICARE Network?
You will pay a full retail price for your drug if you fill your prescription at a non-network pharmacy. Then you will file a claim for reimbursement which will be subjected to an out-of-network cost-share.
Is there a specialty pharmacy for TRICARE
From January 1, 2023, Accredo will be the primary TRICARE in-network specialty pharmacy. You can switch to Accredo if you get specialty drugs in any of the affected pharmacies.
What Other Options do I have?
Through TRICARE Pharmacy Home Delivery or a military pharmacy, you might locate a less expensive option. Check the pharmacy copayments for your health plan here.
Use a free prescription card at RxLess to save on your medications. Whether you take a medication every day like Lipitor or take it for a short time, like Amoxicillin, the discounts found on rxless can save you money. Better yet, they are accepted at over 70,000 pharmacies nationwide including CVS, Walgreens and Rite Aid.
