TRICARE For Life pharmacy pilot
Are you using TRICARE For Life?
Do you fill your prescript ions at a TRICARE network pharmacy?
If you said “yes” to both questions, you may have to participate in the new TRICARE For Life Pharmacy Pilot Program. The program will apply to select maintenance medications obtained from a retail pharmacy after March 14. The Pilot requires you to fill prescriptions for select maintenance drugs through home delivery or at a military pharmacy.
You must participate in the Pilot if you:
• Use TRICARE For Life
• Live in the United States
• Have a prescription for a drug covered by the Pilot.
You don’t have to participate in the Pilot if You:
• Are an active duty family member
• Have other prescription coverage
• Have a prescription for a drug not covered by the Pilot.
• In some scenarios, you may get a waiver from participating in the Pilot.
Drugs Covered by the Pilot
Maintenance drugs are those that you take regularly for a chronic condition (i.e. high blood pressure, high cholesterol). To see if your drugs are covered by the Pilot:
• Call Express Scripts at 1-877-363-1303.
• View the list of select maintenance drugs at http:// pec.ha.osd.mil/TFL_ maintenance_ drug_ list.php
How the Pilot Works
Express Scripts will tell you if you have to participate in the Pilot. Letters to affected beneficiaries will begin being sent February 18, 2014.
Starting March 14 when you fill a prescription for a drug covered by the Pilot at a network pharmacy, you’ll get a letter. When you get this letter:
• Review your options for filling prescriptions.
• Make a decision about filling your prescriptions in the future.
• If you fill your prescription a second time at a network pharmacy, you’ll get another letter from Express Scripts about switching to Home Delivery.
• If you fill your prescription a third time at a network pharmacy, you’re responsible to pay 100 percent of the cost.
To ensure you get these letters, please make sure your address is correct in the Defense Enrollment Eligibility Reporting System. You can verify and update your DEERS record online at https://www.dmdc.osd. mil/milconnect or by calling 1-800-538-9552.