FALLS CHURCH, Va. – The expiration of the retail pharmacy contract between Express Scripts, Inc. (ESI) and the Walgreens pharmacy chain means Walgreens is no longer a TRICARE pharmacy network provider as of Jan. 1, 2012.
“The majority of beneficiaries have access to another network pharmacy very close to home as our pharmacy contract requires ESI to maintain high access standards,” said Rear Adm. Thomas McGinnis, chief of the TRICARE Pharmaceutical Operations Directorate. “There are still 56,000 network pharmacies nationwide – easily meeting or exceeding our access requirements.”
In addition to 56,000 network pharmacies, TRICARE beneficiaries have other pharmacy options including military pharmacies at no cost and convenient TRICARE Pharmacy Home Delivery. Generic medications are available at no cost through Home Delivery.
Beneficiaries who use non-network pharmacies, including Walgreens, pay full prescription costs upfront and submit their own claims for reimbursement. Reimbursement will occur only after the non-network deductible is met. Out-of-network costs include a 50 percent point-of-service cost share for TRICARE Prime, after deductibles are met. All other non-active duty TRICARE beneficiaries pay the greater of a $12 copay or 20 percent of the total cost for formulary medications and the greater of $25 or 20 percent of the total cost for non-formulary medications, after deductibles are met.
For more on pharmacy costs go to www.tricare.mil/pharmacycosts.
TRICARE beneficiaries changing from Walgreens pharmacy can simply take their current prescription bottle to their new network pharmacy to have the prescription transferred. To find a nearby network pharmacy, use the “find a pharmacy” feature on www.express-scripts.com/tricare. Beneficiaries who want help finding a pharmacy, changing their medications to Home Delivery or who have other questions can contact Express Scripts at 1-877-885-6313.
The issues between ESI and Walgreens are not specific to TRICARE. Other employer-sponsored and some Medicare Part D pharmacy plans are also affected. Beneficiaries with questions and concerns about this issue can go to www.tricare.mil/walgreens for more information.
“We are committed to ensuring all our pharmacy beneficiaries are aware of the many options that TRICARE makes available to them,” said Brig. Gen. Bryan Gamble, TRICARE Deputy Director. “By now, all of our beneficiaries who use Walgreens to fill prescriptions should have been contacted to advise them of their pharmacy options and to take action to ensure their pharmacy benefit remains uninterrupted. The health of our Service members, retirees and their families remains my number one priority.”
In addition to the letters already mailed to each beneficiary who uses Walgreens, ESI has contacted many beneficiaries by telephone and followed up with reminder letters over the last few months of 2011. Beneficiaries taking medications to treat hemophilia, multiple sclerosis, and some rheumatoid arthritis and cancer drugs have also been contacted.
TRICARE pharmacy information and updates can be found at www.tricare.mil/pharmacy.
Sign up for TRICARE e-mail updates at www.tricare.mil/subscriptions.
The TRICARE Management Activity administers the worldwide health care plan for 9.6 million eligible beneficiaries of the uniformed services, retirees and their families.