The most recent TRICARE pharmacy contract, known as TRICARE Pharmacy 5th Generation (TPharm5), started on Jan. 1, 2023. Since then, you may have experienced some enhancements to how you get your prescription drugs. In 2024, you can continue to expect improved access to pharmacy benefit services through the TRICARE Pharmacy Program.
“The Defense Health Agency listened to our beneficiaries’ concerns and needs. We responded with several enhancements to the pharmacy contract that went into effect last year,” said U.S. Public Health Service Cmdr. Teisha A. Robertson, Deputy Chief of the Purchased Care Branch at the Defense Health Agency. “This year, we’ll continue to roll out improvements. These improvements include new specialty pharmacy services, cost control measures, and a more efficient home delivery process.”
Here are some TRICARE Pharmacy Program updates to note.
2024 cost updates
Your options for filling your prescriptions are military pharmacies, TRICARE Home Delivery, retail network pharmacies, and non-network pharmacies. Prescription copayments for most beneficiaries changed on Jan. 1. To see your costs, check out the TRICARE Costs and Fees Fact Sheet. As noted in this fact sheet, active duty service members (ADSMs) pay nothing for covered drugs from military pharmacies, home delivery, and retail network pharmacies.
Want to know the copayment for your prescription? Check the TRICARE Formulary Search Tool. You can search for your drug to see if it’s covered, how much it will cost, and where you can get it.
Military pharmacy tools
If you get prescriptions at a military pharmacy, you may be able to use certain tools to avoid long pick-up lines. Check with your military pharmacy to see if it offers these tools:
- Q-Anywhere lets you quickly activate a new prescription by texting your military pharmacy or scanning your pharmacy’s unique QR code. You’ll get a text when your prescription is ready for pick-up.
- ScriptCenters are automated kiosks and locker systems that give you a safe, secure way to pick up prescriptions. You can use them to pick up prescriptions after hours or avoid crowds at the pharmacy. Each location sets its own hours, but some are open 24/7.
TRICARE Home Delivery
TRICARE Home Delivery is a convenient way to have up to a 90-day supply of medication shipped right to you.
With home delivery, you can manage your prescriptions from the Express Scripts Pharmacy Mobile App. You’ll also have 24/7 access to pharmacists who can answer questions about your prescription.
The TRICARE Pharmacy Program is also making sure that you only receive your medications when you need them. Express Scripts requires you to give consent on every refill in the Automatic Refill Program. You’ll need to consent via email, text message, or phone call before Express Scripts will fill your prescription.
Specialty drugs changes
Effective March 1, Accredo provides specialty drugs and enhanced clinical services if you fill TRICARE-defined specialty prescriptions with TRICARE Home Delivery. Accredo is in the TRICARE network as a retail pharmacy.
With Accredo, you have 24/7 access to a clinical care team who can help you manage your treatment with specialty drugs. These expanded services are provided at no extra cost beyond your TRICARE cost-share.
This change improves cost efficiency in the Military Health System (MHS). Increasing the use of home delivery helps the MHS keep your prescription costs lower.
If you already get your specialty drug through home delivery, your prescription has been transferred to Accredo. If you were getting your prescription at a network pharmacy, Express Scripts contacted you. To contact Accredo, call 1-877-882-3324. An Accredo patient care advocate will work with you and your military or civilian prescriber as needed. To learn more, go to Accredo.
TRICARE retail network pharmacies
Looking for a retail network pharmacy in your area? You may find that there’s a network pharmacy closer than you thought. TPharm5 network access standards state there must be at least one pharmacy within 15 minutes driving time of 90% of TRICARE beneficiaries.
It’s easy to find a retail network pharmacy near you with the Express Scripts Find a Pharmacy tool. Enter your ZIP code to see a map of network pharmacies nearby.
Stay updated on your pharmacy benefit throughout 2024. Read more about the TRICARE Pharmacy Program or attend the March 14 pharmacy webinar.
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