A MOAA member recently contacted us with a concern about TRICARE policy related to refill limits for her child’s continuous glucose monitor (CGM) supplies. Without notice, CGM transmitters and sensors were limited to 30-day refills, versus the previous 90-day refill policy.

CGMs have become essential for effectively monitoring and managing blood glucose levels. CGM systems track blood sugar levels day and night, intermittently collecting readings automatically. Data collected from CGMs can help detect trends and patterns, and help patients and medical providers better manage diabetes or other medical conditions.

The 30-day refill limit on CGM transmitters and sensors put families in the position of managing just-in-time supply replenishment and increased the risk of losing access to the CGM while waiting for refills.

Together with the National Military Family Association, MOAA contacted the Defense Health Agency (DHA) to get more details on the CGM refill policy change, convey the MOAA member’s concern, and discuss what would be required to revert to the 90-day refill policy.

DHA quickly determined the reason behind the change and made a TRICARE Policy Manual update to lift the 30-day limit. DHA officials also communicated the update to managed care support contractors and ensured the contractors educated their durable medical equipment (DME) vendors. The MOAA member confirmed that the next time she placed a CGM supply order with the DME supplier, the refill was back to a 90-day supply.

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The CGM refill policy was fixed in less than one month with DHA’s assistance, but not all TRICARE issues can be addressed this quickly. Many TRICARE policies are governed by statute and require legislation to be changed. Others involve the federal rule-making process and require DHA follow a set of procedures prescribed in law and executive order to write regulations. Budget and funding constraints can also present barriers to addressing TRICARE issues.

We appreciate DHA’s quick response to the CGM issue, but also recognize that other issues will take more persistence – or even a legislative fix. We sometimes spend years working toward solutions for specific military health care issues – for example, expanding TRICARE coverage to include chiropractic care, improvements to the TRICARE ECHO program, and efforts to introduce more flexibility into the TRICARE pharmacy copay structure, among others.

MOAA is committed to ensuring the military health care benefit works for beneficiaries. Do you have an issue with TRICARE? Let us know at legis@moaa.org.