In addition to the DoD proposal to increase TRICARE Prime enrollment fees for military retirees under 65, the 2012 Budget proposal includes a plan to increase co-pays on prescription medications.
Under the proposed 2012 budget, TRICARE prescriptions filled on base will remain free, but, co-pays for medications purchased at retail pharmacies will increase. DoD is hoping that the increased co-pays will encourage beneficiaries to use TRICARE's mail-order "home delivery" option.
If passed the current $3 co-pay for generics at retail outlets will increase to $5 and the $9 co-pays for brand name drugs will climb to $12. "Tier 3" (non-formulary brand) drugs, which currently cost beneficiaries a $22 co-pay will be raised to $25 for both mail order and retail. In addition, the plan would remove the $3 charge for mail order generic drugs. The new co-pays could save the DoD $2.6 billion over five years.
Read Tom Philpott's Military Update to learn more.
Here is a chart comparing the current and proposed TRICARE co-pays.
Generic | Brand Formulary | Tier 3 (Non-Formulary) | |
Current Benefit | |||
Retail | $3 | $9 | $22 |
On-Base | $ - | $ - | $ - |
Mail Order | $3 | $9 | $22 |
Proposed Benefit | |||
Retail | $5 | $12 | $25 |
On-Base | $ - | $ - | $ - |
Mail Order | $ - | $9 | $25 |