Military Advantage

HASC Says No to TRICARE Fee Hikes


Last week the House Armed Services Committee completed the 2013 defense bill mark-up. The HASC budget proposal will now go to the full house for a vote. The proposal is expected to pass in the House next week. But it stands little chance of passing in the Senate.

Although committee chair, Rep. Buck McKeon (R-CA), stated that the fee increases would not make it through the HASC, military retirees were relieved to see that the House version ommitted the tiered TRICARE Prime enrollment fees and new TRICARE Standard and TRICARE for Life enrollment fees proposed by the President.

However, in an effort to control DoD’s drug costs, the committee chose to increase co-pays on brand-name prescriptions filled at retail pharmacies and the TRICARE mail order program and create a five-year pilot program that will force TRICARE for Life beneficiaries to get their maintenance drugs through the TRICARE Pharmacy Home Delivery program for at least one year, with the opportunity opt out afterwards.

Comparison of Proposed Proposed Pharmacy Co-Pays

Source Current Co-Pays DoD Proposal HASC Proposal
Generic $5 $5 $5
Brand Name $12 $26 $17
Non-Formulary* $25 N/A $44
Mail-Order – 3 month fill      
Generic $0 $0 $0
Brand $9 $26 $13
Non-Formulary $25 $51 $43
Military Treatment Facilities No Change – Remains $0 Co-Pay
* Non-Formulary pharmaceuticals will have limited availability in retail pharmacies

Tom Philpott reports that the committee's defense bill would also tie annual drug co-payment increases to the cost-of-living adjustments for military retirees, dumping the Obama administration's plan to adjust TRICARE fees and co-pays to keep pace with medical inflation. (Read the Military Update to learn more)

According to Military Update, the Senate Armed Services Committee will mark up its version of the defense bill in late May. The Senate version is likely to include the administration's TRICARE fee increases. 

On Thursday Secretary of Defense, Leon Panetta, slammed the HASC for adding billions of dollars to President Barack Obama's defense budget.

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