Out-of-Pocket Costs for US Armed Forces Veterans to Rise

Tricare to increase its copay for prescription drugs starting February 1, 2016.

Veterans of the United States Armed Forces administered prescriptions through a veterans’ pharmacy will soon see their out-of-pocket costs grow.

Tricare Pharmacy will increase the copay for veterans, as a freeze previously put in place had expired.

In September 2015, the Federal Register ruled that the Department of Veteran Affairs (VA) would extend the freeze on co-payments through the end of 2016.

However, the National Defense Authorization Act (NDAA) is now requiring Tricare to increase its copay for prescription drugs starting February 1, 2016.

All drugs obtained at military pharmacies and generic drugs sent via home delivery will still be available at no cost, according to Tricare.

The copays for brand name drugs from home delivery will increase by $4 ($16 to $20) for a 3-month supply. Veterans who receive generic drug prescriptions from retail pharmacies will have their copays increase from $8 to $10, while brand name copays will jump from $20 to $24 for a 1-month supply.

Although the switch from pharmacy to home delivery will save beneficiaries up to $208 in 2016, VA officials previously expressed concern for the payment hike.

The rise in out-of-pocket costs may potentially lead to fewer veterans using their pharmacy benefits.

Changes first started taking place in October, when Tricare covered military families and veterans had to pay out-of-pocket for certain brand name “maintenance medication” drugs that they obtained from a retail pharmacy.

These maintenance medications are used to treat those suffering from chronic health issues. Although at that time, Tricare was still covering acute conditions that used drugs like antibiotics.

In 2014, the Tricare for Life pilot program for retired veterans first explored these co-pay changes, but participants were able to opt out after a year. This option will not, however, be available as part of the new rule.

To learn more about the upcoming changes, please visit www.tricare.mil/pharmacy.