TRICARE improvements for beneficiaries' care Published Oct. 11, 2011 By Connie Hempel 17th Training Wing Public Affairs GOODFELLOW AIR FORCE BASE, Texas -- From prescription refills to transferring enrollment, TRICARE beneficiaries have seen a lot of changes in their healthcare plan in the past few months, and more are on the way. "Through patient feedback and program assessments, TRICARE staff have made changes that are geared to ensuring beneficiaries receive quality care in a timely manner," said Capt. David Abbott, 17th Medical Group Patient Administration Flight Commander. VACCINES TRICARE has expanded the list of vaccines that beneficiaries can get at participating TRICARE Network pharmacies. A list of these pharmacies, vaccines and any restrictions can be found at: www.express-scripts.com/TRICARE/pharmacy/. "State laws effect which vaccine can be given at a pharmacy, so not all pharmacies can give every vaccine," Abbott said. "It's best to call the Network pharmacy ahead of time to see if they give vaccines, which ones, and if they have the needed vaccine on hand." TRANSFERRING REGIONS Changes to the portability form and process simplify moves for active-duty service members and their family by allowing them to call or visit a TRICARE Service Center and inform them of an upcoming move. After contacting the TRICARE Service Center, their information will be sent to their new Regional Contractor ahead of time. TRICARE FOR YOUNG ADULTS TRICARE Young Adults offers TRICARE Standard coverage worldwide to qualified family members with TRICARE Prime coverage available for purchase at a later date. The program includes medical and pharmacy benefits, but excludes dental coverage. Qualified family members include those who have a TRICARE eligible sponsor, are age 21 or 23 if they are a full-time college student, are not married, are not eligible for their own employer-sponsored coverage or Transitional Assistance Management Program (TAMP), and are not enrolled in another TRICARE program or Continued Health Care Benefit Program (CHCBP). "This is a great program for adult children moving towards independence from their parents," Abbott said. ENROLLMENT FEES Starting this month, enrollment fees for new TRICARE Prime applicants have increased. The new fee for an individual is now $260, and $520 for a family. "If you're already enrolled in TRICARE Prime, you will not see an increase this year, but remember that enrollment fees are subject to increase each fiscal year," Abbott said. "There are also two categories of enrollees who are exempt from any TRICARE Prime rate increase: medically retired service members and survivors of active-duty deceased." The enrollment fee for medically retired service members and their family, and survivors of active-duty deceased and their family is frozen at the rate that was in effect at the time they were classified. "As always, active-duty service members and their family do not pay an enrollment fee," he said. PRESCRIPTIONS Prescription co-pays at retail and through home delivery have undergone changes too. Retail store prescription fills based on a 30-day supply are as follows: generics, $5; formulary brands, $12; and non-formulary brands, $25. Home delivery prescription fills based on a 90-dy supply are as follows: generics, $0; formulary brands, $9; non-formulary brands, $25. There is no cost to have prescriptions filled at the Ross Clinic; however, the clinic does not provide non-formulary prescriptions. These must be filled at a retail store or through home delivery. WALGREENS LEAVES THE TRICARE NETWORK Starting Jan. 1, Walgreens will no longer be part of the TRICARE Network. After Dec. 31, beneficiaries who fill prescriptions there will have to pay 100 percent of the cost and will need to file a paper claim for non-network benefit reimbursement. The TRICARE website, www.TRICARE.mil, provides the latest updates to changes, explanation of benefits, and a link for beneficiaries to provide feedback. People can also contact the TRICARE service center at (800) 444-5445, or visit the TRICARE service center located in the lobby of the Ross Clinic.
