Editor’s note: This article by Amanda Miller, with contributions from Amy Bushatz, originally appeared on Military.com, a leading source of news for the military and veteran community.

Tricare users who receive prescriptions by mail now need to confirm their refills before they are sent, a change that could cause disruptions for millions of beneficiaries if they don’t immediately respond to the confirmation messages and take the needed steps.

Express Scripts, Tricare's pharmacy benefits manager, let patients know in December that the Tricare Mail Order Pharmacy Program would stop sending refills automatically without any confirmation.

The change was in part to "prevent excess waste," a Defense Health Agency spokesperson told Military.com. The federal government is currently suing Express Scripts for allegedly sending out too much medication. That suit claimed the system sent 90-day refills every 60 days, giving patients 73% more tablets than prescribed over a year.

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Now reminders are going out in advance of a prescription's scheduled shipping date via beneficiaries' preferred communication method -- email, text message or phone call. You can log in to your account if you need to change your preferred method, or call customer service for help.

Patients who choose a phone call and miss the refill notification can call back at 877-363-1303 in the U.S. and choose the option for patients who received a call and need to consent to the refill.

If you don't confirm a refill, or if you opt out for a month, that prescription will no longer be part of the auto-refill program, and you'll have to re-opt into automatic refills, according to Express Scripts' Military Rx blog. However, reminders will keep going out until the prescription expires.

Copayments for mail-order drugs are $2-$4 less for generic or brand-name drugs than at retail pharmacies for non-maintenance medications. Maintenance medications, which include prescriptions taken daily for many months at a time such as cholesterol or thyroid medication, must be received by mail or in an on-base pharmacy after the initial fill. Refills of maintenance medications are not covered at retail pharmacies. Specialty medications not in Tricare's formulary aren't any cheaper by mail.

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The steps for approving refills via the Express Scripts website are fairly straightforward, according to a system test by Military.com. Here's what to do for emailed reminders:

• Go to your emailed refill-approval notice sent by Express Scripts.
• Click the "approve refill" button displayed in the email.
• A new browser tab will open requesting that you "login to Tricare" or register for an account.
• Fill in your login details and click the "login" button. Then be patient -- moving to the next page can take several seconds.
• On the new page, you'll see a screen displaying any prescriptions with available medications and a drop-down menu for each. The options in that menu include "approve auto refill," "refill and stop auto refills" and "do not refill." Select the option that best meets your needs.
• If you select "approve auto refill," a new pop-up window will ask you to either "approve" or "cancel." Clicking "approve" loads a new page with a green confirmation check mark and notice of the name of your medication and the date the refill will begin to process. (For example, the medication tested by Military.com was eligible for refill Feb. 1, but the notice that approval was needed was received by email Jan. 22. Approving the refill resulted in a notice that the prescription "will process on 2/1/2023.")