Wednesday, June 26, 2013

More Information on Tricare Insurance Not Covering Compounded Medications


NEW - Important Information About Your Compounded Medications

The TRICARE pharmacy benefit covers medications approved by the Food and Drug Administration (FDA). Some compound prescriptions use ingredients that aren't FDA-approved as safe and effective. Pharmacy compounding is a practice in which a licensed pharmacist combines, mixes, or alters ingredients of a drug in response to a prescription to create a medication tailored to your medical needs. For the safety of beneficiaries, when a compound prescription has an ingredient that isn't FDA-approved, TRICARE won’t cover the prescription.
Express Scripts is sending letters to beneficiaries who are using compound prescriptions that TRICARE will no longer cover as of July 24, 2013. TRICARE policy on compound prescriptions hasn’t changed. Clickhere (PDF file) to view an example letter. You can also view an example letter by visiting the Source Documents tab of the Customer Service Community website atwww.tricare.mil/customerservicecommunity/source.aspx under the Pharmacy Notifications button.
What you need to do
  • Please consult 32 CFR 199.4(d)(3)(vi)(B) for more information. Additional requirements for medication coverage are detailed on the following web site:http://www.tricare.mil/Pharmacy/Medications.aspx
  • If you are still using this medication please talk with your doctor to see if there is an appropriate alternative that is covered.

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