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Higher Rx co-pays: Prescriptions filled on base would remain free but co-pays at retail outlets and mail order would increase, most sharply for brand name medicines. The changes largely would impact retirees and their families.
The $17 co-pay at retail for brand name drugs on the military's formulary would jump to $26 initially and see annual increases until reaching $45 by 2024. The $5 co-pay for generic drugs at retail would increase by $1 a year until 2024.
The co-pay of $13 for mail order brand name drugs on formulary would double to $26 next year and reach $45 by 2024. Generic drugs would be free if filled by mail until 2019, then a $9-co-pay would be charged for a 90-day supply.
Drugs not on the formulary cost $44 to fill at retail pharmacies. Under the Senate bill, non-formulary drugs would be available by mail order or on base, not at retail outlets, starting next year. The $41 mail order co-pay for a three-month supply would jump to $51 and increase annually to reach $90 by 2024.
In March, Tricare began requiring older beneficiaries to get all maintenance medicines for chronic conditions by mail or on base, for at least a year. The Senate bill would make this requirement permanent and expand it to impact all retirees and their family members.
Exempted from higher co-pays would be members medically retired, spouses of members who die on active duty and family members of both groups.
The higher co-pays would save the Defense health program $1.5 billion in direct costs by 2019 and $3 billion more in accrual payments into a fund set up to cover health costs of military retirees also eligible for Medicare.read more
Higher Rx co-pays: Prescriptions filled on base would remain free but co-pays at retail outlets and mail order would increase, most sharply for brand name medicines. The changes largely would impact retirees and their families.
The $17 co-pay at retail for brand name drugs on the military's formulary would jump to $26 initially and see annual increases until reaching $45 by 2024. The $5 co-pay for generic drugs at retail would increase by $1 a year until 2024.
The co-pay of $13 for mail order brand name drugs on formulary would double to $26 next year and reach $45 by 2024. Generic drugs would be free if filled by mail until 2019, then a $9-co-pay would be charged for a 90-day supply.
Drugs not on the formulary cost $44 to fill at retail pharmacies. Under the Senate bill, non-formulary drugs would be available by mail order or on base, not at retail outlets, starting next year. The $41 mail order co-pay for a three-month supply would jump to $51 and increase annually to reach $90 by 2024.
In March, Tricare began requiring older beneficiaries to get all maintenance medicines for chronic conditions by mail or on base, for at least a year. The Senate bill would make this requirement permanent and expand it to impact all retirees and their family members.
Exempted from higher co-pays would be members medically retired, spouses of members who die on active duty and family members of both groups.
The higher co-pays would save the Defense health program $1.5 billion in direct costs by 2019 and $3 billion more in accrual payments into a fund set up to cover health costs of military retirees also eligible for Medicare.read more
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