TRICARE, the health care program for active-duty service members, military retirees, reservists and their families, will drop more than a quarter of the pharmacies in its current network later this month, a move that will force an estimated 400,000 beneficiaries to find new pharmacies.
The program said nearly 15,000 independent, community pharmacies will no longer be in the TRICARE network as of October 24. The network will still include more than 40,000 pharmacies across the country.
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Military members and their families were notified about the drop in coverage last month. The Military Officers Association of America (MOAA) said military families in rural areas will be most affected by the change, especially those already affected when Walmart/Sam’s Club left the TRICARE network last year.
MOAA estimaetd that nearly 400,000 beneficiaries will now need to find other pharmacies as a result of the change, which is about 4% of the TRICARE-eligible population.
Pentagon spokesman Charlie Dietz said TRICARE will continue to “meet or exceed” its standards for pharmacy access.
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“Beneficiaries will continue to have many convenient, local in-network options for filling their medications, including those beneficiaries in rural locations,” he said. “Nearly 95 percent of beneficiaries will maintain access to at least two network pharmacies within 15 minutes from their home, and 99.8 percent will have access within 30 minutes.”
The decision to drop smaller pharmacies from the network came after Express Scripts, TRICARE’s pharmacy contractor, cut pharmacy reimbursement rates to the point where it became “impossible for many independent community pharmacies to participate in the TRICARE pharmacy network,” according to the National Community Pharmacists Association.
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The group urged its members to sign onto a letter in late September asking why the program is making it harder for beneficiaries to access pharmacy services. The group said the actions of Express Scripts are “taking away pharmacy choice and creating disruptions for TRICARE beneficiaries and their caregivers and making it more difficult for many to access their necessary prescriptions.”
