More TRICARE Hikes Are in the Offing

It looks like military retirees covered by TRICARE will end up paying a little more for their prescription drugs, but not as much as the Obama administration would like.

Sen. Jack Reed, D-R.I., offered an amendment to the fiscal 2013 Defense authorization bill Wednesday that would modestly increase TRICARE co-payments for name-brand and nonformulary drugs next year, according to a Nov. 28 report inArmy Times. It also would cap pharmacy co-pays beginning in 2014 so that such fees are in line with the annual retiree cost-of-living adjustment. The costs associated with the fee increases would be offset by a pilot program requiring TRICARE for Life recipients to obtain maintenance drug refills through the mail.

Reed’s amendment, which is similar to a provision in the House-passed version of the fiscal 2013 Defense authorization, would result in co-pays of $17 for brand-name drugs at retail pharmacies and $44 for nonformulary drugs, according to Army Times. Co-pays for 90-day prescriptions obtained through the mail would increase to $13 for brand-name drugs and $44 for nonformulary medication under Reed’s amendment.

President Obama has proposed higher increases for drug co-payments at pharmacies and through the mail. Under the administration’s proposal, TRICARE beneficiaries would pay $26 for a brand-name prescription at the pharmacy and through the mail for a 90-day supply; the White House has proposed a $51 co-pay for a three-month supply of nonformulary drugs received through the mail.

TRICARE beneficiaries would retain the $5 monthly co-pay for generic drugs obtained at a retail pharmacy under every scenario.

Lawmakers from both parties typically have been loath to raise health care costs for TRICARE retirees. So far, both chambers have rejected the administration’s more aggressive proposals to increase the fees and other costs beneficiaries pay for their health care. But the issue isn’t going anywhere as the Defense Department continues to look for ways to rein in spending on pay and benefits, which now account for about one-third of the Pentagon’s budget. It’s highly likely that Obama’s fiscal 2014 budget blueprint will include recommendations to increase the amount military retirees contribute to TRICARE.

 

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