Starting Feb. 28, active duty family members who live far from a military hospital or clinic, and who are enrolled in Tricare Prime Remote in the United States, will get their covered prescriptions for free.
They’ll have $0 copayments for prescriptions filled at retail network pharmacies as well as through the Tricare Pharmacy Home Delivery, according to an announcement Tuesday by the Defense Health Agency. It applies to all covered prescriptions, including generic drugs, brand-name drugs and non-formulary drugs.
“This change will help military families without access to military pharmacies keep their pharmacy costs down,” said U.S. Public Health Service Cmdr. Teisha Robertson, chief of the Pharmacy Integration Branch at the Defense Health Agency, in an announcement of the waiver. Patients can fill prescriptions at military hospitals or clinics at no cost.
The waiver will save these active duty family members $16 for a 30-day supply of generic drugs and $48 for brand-name medications filled at retail network pharmacies. For those using the mail order pharmacy, it will save $14 for a 90-day supply of generic drugs and $44 for name-brand drugs.
These families who are filling prescriptions for non-formulary drugs will save $85, and will still be required to get a medical necessity approval from Express Scripts. Otherwise they’ll have to get the prescription filled at a retail pharmacy and pay the full cost of the drug.
By law, families can enroll in Tricare Prime Remote if both the sponsor’s home and work addresses are more than 50 miles, or a one-hour drive, from a military hospital or clinic.
About 167,000 beneficiaries were enrolled in Tricare Prime Remote by the end of fiscal year 2023, according to the latest numbers available. Information wasn’t immediately available about whether that number includes Tricare Prime Remote beneficiaries overseas.
This waiver doesn’t apply to those overseas, according to Defense Health Agency officials. Active duty families enrolled in Tricare Prime Remote Overseas will still pay the pharmacy copayment.
Tricare beneficiaries don’t pay for prescriptions at military pharmacies. Active duty personnel don’t pay cost-shares or co-pays at retail pharmacies for covered medications.
Active duty family members won’t have to take action for the change to take effect, and they won’t have to file their own claims for reimbursement, officials said. Those who fill a covered prescription starting Feb. 28 will automatically have a copayment of $0.
“We welcome this new policy, which honestly is long overdue,” Eileen Huck, director of government relations for the National Military Family Association, told Military Times. “Families shouldn’t have to pay more for their prescriptions simply because they are not stationed near a [military treatment facility.]
“We appreciate that DHA recognized the needs of families in Tricare Prime Remote locations and made this change.”
Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book “A Battle Plan for Supporting Military Families.” She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.
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