Military Advantage

Proposed TRICARE Pharmacy Co-Pays and More...

Military.com contributor, Tom Philpott, recently wrote an excellent article covering some of the details found in the Senate Armed Services Committee’s version of the 2012 National Defense Authorization Act. Tom pointed out a couple things I think are worth noting concerning some of the benefits and compensation changes addressed in the bill.

Since I have covered most of the issues surrounding TRICARE in previous posts, I’ll stick to a couple of points that I have not covered in quite as much detail.

TRICARE Pharmacy Co-Pays In addition to increasing TRICARE Prime enrollment fees for working-age retirees, the Senate has approved restructuring of TRICARE pharmacy co-payments to encourage use of mail order for refills. The restructuring will mean increasing the co-pay for generic medicines at retail outlets to $5. TRICARE’s home delivery program will continue to offer up to 90 day supplies of medications for $3.

In addition, co-pays for brand name drugs will increase to $12 at retail pharmacies and the co-pays for non-formulary brand drugs will be raised to $25, for both mail order and retail.

According to the article, the new co-pays are projected to save $2.6 billion over five years, or five times the savings projected from higher TRICARE Prime fees on working age retirees.

Combat Pay Changes Under current law, spending only part of a day in a war zone or imminent danger area makes a member eligible for the full $225 payment. The Senate version of the bill requires that the monthly Imminent Danger and Hostile Fire pays no longer be paid in full to those who are in the designated zones for less than a full month. Instead, these special pays would prorated based on the number of days spent in a war zone.

According to the Senate ASC this change would save $30 million a year. This would greatly reduce the cost associated with persons on temporary assignments like fight crews. Tom reports that the committee had been given reports of “military personnel attending first-of-the-month change of command ceremonies in war zones and, by arriving a day early and departing immediately after the ceremony, qualifying for two months of danger pay.”

I highly recommend reading the full article, ‘New TRICARE Fees, End to Combat Pay 'Windfalls' Voted’ for some great insight on the changes and the Senate’s rationale.

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