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Tricare prescription copays to rise soon
Tricare beneficiaries soon will pay higher copayments for brand-name and non-formulary prescriptions that are not filled at military clinics or hospitals. There is no increase to copays for generic medications.
The increases, which Tricare said are expected to kick in sometime in February depending on the timing of system changes, are required by the 2013 National Defense Authorization Act.
The new copay for a 30-day supply of a brand-name drug purchased at a retail network pharmacy will be $17, up from the current $12. Users of Tricare's mail home delivery service will pay $13 for a 90-day supply of brand-name drugs, up from $9.
The copay for generic medications remains at $5 if a prescription is filled at a network pharmacy; there is no copay for generics filled through mail delivery.
Copays for non-formulary medications—those not listed on the approved Tricare Uniform Formulary because they are too new or expensive—will increase from $25 to $44 at retail pharmacies and $43 through home delivery.
From fiscal 2014 on, the new law requires copays to increase every year by the same percentage as retiree cost-of-living adjustments. Any increase less than a dollar will be delayed and combined with the next year's adjustment, so increases will always be $1 or more, Tricare said.