TRICARE beneficiaries with prescriptions for specialty drugs through a retail pharmacy may need to make new arrangements to receive their medication after a March 1 TRICARE policy change that expanded the list of maintenance medications beneficiaries must refill through home delivery or at military treatment facilities (MTFs).

Patients taking medications newly added to TRICARE’s maintenance drug list as of March 1 will have a limited time – two refills – to move their prescription to either a military pharmacy or TRICARE Home Delivery, according to a Feb. 6 TRICARE.mil article. The move comes as Accredo, a specialty pharmacy, takes over all specialty prescriptions filled via the home delivery option.

This change impacts fewer than 1% of TRICARE beneficiaries. Those impacted have been notified by mail.

[RELATED: MOAA's TRICARE Guide]

Accredo became the primary option for these medications under TRICARE last year. The pharmacy offers a clinical care team 24-7 to answer medical questions; beneficiaries interested in moving prescriptions to Accredo can call (877) 882-3324 to learn more.

Your Resources

More information about Accredo’s TRICARE services can be found on the pharmacy’s website. Other online resources that may prove helpful as part of this transition include:

• TRICARE Formulary: This search tool will show beneficiaries where their prescribed specialty drugs are available.
  
  
• Cost Comparison: Prescription costs may change for beneficiaries moving from a retail pharmacy to home delivery. This site will offer a breakdown of charges based on plan type. Beneficiaries already receiving medication through the mail will not see a copay change.
  
  
• Accredo Mobile App: This tool allows beneficiaries to manage medications, track orders, and set dosage reminders. It’s available via the Apple App Store and Google Play (Android).
  
  
• TRICARE Specialty Drug List: Provides a list of specialty drugs, updated periodically (Microsoft Excel download).
  
  
• Maintenance Drug List: List of drugs TRICARE requires beneficiaries (excluding active duty servicemembers) to refill through mail order or MTF pharmacies. Subject to change.

Note: Not all specialty drugs are on the maintenance drug list – some can still be obtained through retail pharmacies.

[RELATED: TRICARE For Life, Star Act, Housing Help Will Anchor MOAA’s Spring Advocacy Push]

About Specialty Drugs

Only 1% to 2% of TRICARE users take specialty medications, which treat chronic conditions and may require special storage and/or clinical training to administer. These include a variety of cancer-fighting medications, as well as treatments for multiple sclerosis and hepatitis C.

While these drugs represented less than 1% of military health system (MHS) prescriptions in FY 2022, they accounted for roughly half of total drug costs. Estimated MHS spending on specialty medication that year was $3.74 billion, up from $3.37 billion in FY 2021.

While MOAA supports efforts by the MHS to control costs, these must not result in decreased access to high quality care and needed medications.

If you or a loved one has been or will be affected by these specialty drug changes, please share your concerns with us at legis@moaa.org.