FALLS CHURCH, Virginia –
As the new year approaches, make sure you’re aware of changes to the TRICARE Pharmacy Program that may affect you. While these changes offer several enhancements, some of the changes may require action on your part. This will ensure you have access to the prescription drugs you and your family members need.
“Some of the changes you’ll see next year result from changes to the contract with Express Scripts, the company that manages the TRICARE Pharmacy Program,” said U.S. Public Health Service Cmdr. Teisha Robertson, a pharmacist with the Defense Health Agency’s Pharmacy Operations Division. “The increased options you’ll have are part of TRICARE’s next generation pharmacy contract, which focuses on ways to improve the pharmacy benefit for everyone who uses it.”
Here are the four pharmacy changes to prepare for in 2023.
1. Kroger leaves TRICARE network
Kroger pharmacies will no longer be a part of the TRICARE retail pharmacy network. This includes all Kroger’s family pharmacies, including but not limited to:
- Harris Teeter
- Fred Meyer
- Smith’s Food and Drug
- Fry’s Food and Drug
- King Soopers
If you recently filled your prescriptions at a Kroger family pharmacy, you must move to a TRICARE in-network pharmacy before Jan. 1, 2023. You can use Find a Pharmacy to search by ZIP code for a new, in-network pharmacy in your area. Please note, you may still see Kroger family pharmacies listed in the Find a Pharmacy tool before Jan. 1, 2023.
Nearly 90% of TRICARE beneficiaries will continue to have access to at least one retail network pharmacy within 15 minutes’ drive time or less from their location. And almost all beneficiaries will have access within 30 minutes’ drive time or less.
On or after Jan. 1, 2023, if you continue to fill your prescriptions at a Kroger family pharmacy, you’ll pay the full retail price for your prescriptions. If you do this, you can file a claim for reimbursement. Reimbursements are subject to a deductible or out-of-network cost-shares and copayments. This change applies to all prescription drugs, including specialty drugs.
2. Prescriptions require your approval
You’ll need to approve each refill when enrolled in the TRICARE Pharmacy Home Delivery automatic refill program. This ensures you only receive the prescriptions you need. Here’s how the process will work:
- Express Scripts will let you know—via phone, email, or text—that you have a refill coming up.
- You’ll log in to your account or through the free Express Scripts mobile app to confirm you want your next refill. Reminders for your refill will continue until your prescription expires. Keep in mind, if you don’t approve your refill, Express Scripts can’t ship your medication.
- When your medication is ready, Express Scripts will send it to you. If you’ve selected text as your communication preference, you can receive your order status right from your phone. You can use the mobile app to track your order while it’s processed and shipped, as well.
3. More options for electronic notifications
Express Scripts is making it easier for you to be in the know about your prescription drugs. You’ll now have more options to get pharmacy updates, like formulary drug changes, drug recalls, and claims processing. By logging in to your Express Scripts account, you can choose the way you’d like to receive information: email, phone call, or text.
To update how you’d like to receive communications, once in your account, choose “Communications Preferences” from the list, and follow the instructions.
4. Add caregivers to your account
Do you have caregivers you’d like to give access to your Express Scripts account? You can now add them. When you do, you’re authorizing them to manage your prescriptions and Express Scripts account. You can have multiple caregivers on your account. You’ll still be able to manage your account, too.
It’s easy to add a caregiver to your Express Scripts account. Just log in to your account, choose “Add a Caregiver” from the list on the left, and follow the instructions.
Are you budgeting for 2023? Remember, your pharmacy costs aren’t changing. As outlined in the TRICARE Costs and Fees Fact Sheet, pharmacy costs remain the same through the end of 2023.
To learn more about the TRICARE Pharmacy Program, refer to the TRICARE Pharmacy Program Handbook. For more details about the upcoming changes or if you have questions, contact Express Scripts.
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