Like many military things, receiving medication via mail through Tricare pharmacy home delivery confounds me. Once upon a time I somehow managed to get a birth control prescription delivered by mail-order instead of paying for it at Walmart. I'm not even sure how I set it up, honestly. And that's why when the prescription ran out I couldn't figure out how to make it happen again.
The Express Scripts website had locked me out for reasons I didn't really know. My civilian provider seemed completely incapable of getting my renewal called into the Express Scripts system. I gave up, switched the military treatment facility (MTF) and started getting it in-person every three month from the on-base pharmacy.
Yes, the mail-order pharmacy won that battle. But it did not win the war. Because now I'm back, figuring out how the heck to use it so that you can, too.
Why Tricare pharmacy home delivery matters:Plenty of Tricare users will be switching to mail-order for their regular, daily drugs over the next few months thanks to a Tricare rule change. That switch requires non-active duty and non-overseas users to buy name-brand maintenance medication through the mail-order system or pick them up (for free) at the MTF.
If you don't live near an MTF, mail-order is going to be your only option. The time to figure out how to use it is now.
The bonus here is that mail-order is actually cheaper than what you are paying right now at a retail pharmacy -- and an MTF is free. Right now you are paying $60 at a retail pharmacy for 90-day name-brand drug supply. By mail you'll only pay $16 for a 90-day supply. It's pumpkin spice latte time, people. Add that extra cash to your Starbucks fund.
What is a maintenance drug?Maintenance drugs are medications that you take every day to manage a chronic condition. Drugs like Prozac, name-brand cholesterol, blood pressure or allergy medications fall into this category.
Not currently considered a "maintenance" drug? Birth control. That's was weird to me because as far as I'm concerned, birth control is the very definition of a maintenance drug (maintaining my sanity! I kid. Sort of.). But that doesn't mean it won't be added later, Tricare officials said. The current list was put together for pilot program done with the Tricare for Life users, all of whom are over 65-years-old. You know who doesn't use birth control? People who are over 65. And so it isn't on the list.
Tricare officials note that the list of what is considered a maintenance medicine will grow and change -- so stay tuned.
How to switch your current prescription to mail order:If you have a civilian, non-military treatment facility provider (which you probably do if you're worrying about this), you have a few options:
-- You can call Express Scripts and talk to the very nice people (no really, I've tested this -- they are very nice and helped me unlock my account) and they will request it be moved from your doctor for you. You just need to give them the drug name and information and the name of your provider. Boom. They take care of it. If they can't get your doctor's office to respond within 10 days, you'll get an email or letter in the mail (your choice) that it didn't work. If that happens you can try one of these other methods. If you're lucky your doctor's office will confirm it within just a few hours. Their number is: 1-877-882-3335.
-- You can ask your provider to send in your prescription electronically to "Express Scripts Mail Pharmacy." Doing so should not be impossible for them ... but it didn't go so well with my provider, so you're on your own with this one. They can also fax it. The form for that is on the same page as the one I talk about below, so read on.
-- You can print out and mail in a form. Yes, I said "mail." To do this you need to be able to find the form on the Express Scripts website.
Easier said than done? That's why I'm here. Go to the Express Scripts Tricare website. Once you are registered (yeah, I know -- it's a pain) visit the "Health and Benefits Information" tab, and choose "print forms" from the menu. A box will pop-up with the form you need to fill out and mail. To do this you will also need a physical copy of your prescription. And that one I can't help you with.
If you are seen at an MTF and really want to do the mail order thing (even though you'll have to pay for it ... but maybe $16 every 90 days is worth not having to ever go into your MTF pharmacy again), you can ask your provider to fax in an order or you can call Express Scripts and ask them to make a request.
How to get a new prescription into the mail-order system.If you've just been prescribed a new maintenance drug, you probably want to start taking it today -- not in a few weeks when they can get it shipped to your house.
So how should you proceed?
First, fill your prescription for your first month at your retail pharmacy. Tricare will cover your initial purchase under the old $20-per-30-days rate.
Then, call Express Scripts (1-877-882-3335) and ask them to help you move your prescription over to the mail-order system. You'll want to do this sooner rather than later, as it can take a few weeks for delivery of the drug to start.
How to get a prescription from your civilian provider to your local MTF:You have two options:
-- You can hand carry it. But make sure the place you are hand carrying it to will fill prescriptions from providers outside of their specific practice. For example, our local MTF has a community-based satellite office called a "Medical Home" with its own pharmacy. It happens to be located across the street from my kids' civilian provider. Genius that I am, I decided that instead of paying out of pocket at Publix for expensive antibiotic for Chronic Ear Infection Kid, I would just trot that piece of paper across the street and get the drug at the MTF pharmacy. But no dice -- they only fill drugs there are ordered by in-house doctors.
-- You can have it sent electronically. All MTFs accept electronic prescriptions from civilian providers, Tricare officials told me. Easy.
Bonus tip: make sure you research ahead of time whether or not your MTF carries the drug in question. Not all drugs are carried by MTF pharmacies.