Nearly 15K Pharmacies Opting Out Of Tricare

[f16 1ub]

In typical government fashion neatly 15k pharmacies are going to be dropped from Tricares Network filling veterans/beneficiaries scripts because they won’t agree with the contract. It’s all about money but let thee come walking across the border and you’ll be fine. The script stoppage occurs Oct 24. Good luck.

Go to military.com.

[ThomasD]

Thankfully I have a local air force base medical center that has a pharmacy and also takes retires as patients

[1stindoor]

Same, I'm still seeing my PCM on post and getting my meds filled at the pharmacy. Lots of issues here but yep, primarily it comes down to money. Which begs the question why will some pharmacies accept the contract and some won't? Laying all the blame on Tricare isn't right since you could always go the Express scripts route or get them through the VA...if they have them.

[Ship]

No base down here and my pharmacy is off the list here in a few weeks. I'm basically being forced to use one of the big chain pharmacies, Walgreens or CVS and they are terrible around here. Put what I can on Express scripts I guess. I think Tricare is probably ok if you live near a big military town or near a base but it's not to good down here. Not very many providers around here take Tricare. I glad I am not on Medicaid of course but the people that are on it have it made at zero cost.

[1stindoor]

Very true. I live about 7 miles from Fort Bragg and work on post about 1 mile from the clinic and pharmacy. I keep waiting for them to push me off post since I retired more than 9 yrs ago.

[C130]

It's their chance to help support the veterans but it's really only about the mighty dollar that they care about, nothing else. Same ones probably preach they support our military.

Right after 9/11 I got activated and our son was 6 months old. Pediatrician had a huge banner across his office that said "We Support Our Troops" with an American Flag. He wouldn't take Tricare and my wife and I asked him if he'd like to start and we could help him get it set up. He told me no, he wasn't interested and I asked him why not? He said it paid less and he didn't want to lose any money. I told him I'd just taken a 50% pay cut, bought a new house a few months prior, son was 6 months old, wife had to quit work due to my activation. I told him he could take his sign down and stick it up his _ss.

[BarryFL]

Medicaid has better benefits than Tricare. Just put retirees on it. And, yes, I'm retired military. 27 years AD.

[n2ratfishin]

Tri Care for Life is not “at no cost”. You will be required to pay Part B for coverage, currently 170ish per month unless you earn over a certain dollar amount then it goes up with IRMAA. Health Net and Humana are your big Tri Care insurance. They only do what the Feds tell them via contact. Write your federal reps!

PS my dental is also over 100 a month. By time my wife is Medicare eligible we will be at 500.00 a month vs 550ish a year!

https://appropriations.house.gov/new...appropriations

Meanwhile let’s send another 12 BILLION to Ukraine.

[n2ratfishin]

Medicaid has better benefits than Tricare. Just put retirees on it. And, yes, I'm retired military. 27 years AD.

I doubt many want Medicaid. The list of participating docs is slim, think your local health clinics. Tri care has about the same reimbursement rates and lots of admin for the Feds. CMS regulates both “Medis” with about 9,000 federal workers.

[Finnegan]

I told you guy's and gal's years ago this would happen!!!!!!!!!!!!!!!! I had a different sign on name back then however, I told you this would happen. The drug store guy is probably in the 90% of the population of the United States THAT SAY'S THANK YOU FOR YOUR SERVICE that really means thank you for your service so I wouldn't have to TAKE THE OATH.
90% of the population of the United States can give a rat's tail end if you severed or not. They are in one piece and their brain isn't affected by what we saw or experienced!!!!!!!!!!!!!

[Ship]

I doubt many want Medicaid. The list of participating docs is slim, think your local health clinics. Tri care has about the same reimbursement rates and lots of admin for the Feds. CMS regulates both “Medis” with about 9,000 federal workers.

Maybe where you live that is true. Here there are very few Tricare providers, if any in certain fields. How could Tricare have the same reimbursement rate when Medicaid is completely free?

[n2ratfishin]

Medicaid nor Tri-Care are free, both are paid by others. Medicaid is state funds backed by the Feds and Tri-Care is of course federally funded. ..Gov pays private insurance companies to service clients and enforce regulations.

With 70% of military retirees staying in this area indeed we have plenty of docs that take TriCare Prime. Ive lived in cities where not one doc accepted Prime but they would take standard because they knew we would pay the 20%.

Dig far enough on the CMS site and you can find the billing codes and reimbursement rates…or check out your billing statements. Look at what is billed and what is paid. My recent MRI was 750.00 billed and about 200.00 paid. Docs cant keep the doors open without the larger insurance reimbursements. A HMO general practice doc may have a goal of 30 patients seen a day. Do the math on how much time they have to diagnose and treat you.

[Ship]

I'm talking about cost out of pocket for the member. For people on Medicaid it is free regardless of where the money comes from.

[Crestliner16]

Any way you put it, it's just not that good. When I was discharged in 72,the nearest facility was 60 miles away and the coverage was horrible, let alone being able to have the same Physician.
Reading this is disheartening, as it's just more complicated than I thought
Good luck to all of you.

[wtaylor418]

Wow! Sorry you guys are having problems. I am a 22 year Navy Vet, retired in 1988, and have used Tricare continuously since my retirement. I live near a Naval Hospital and have a Primary Care Manager there. They have never, to my knowledge, even filed a Medicare claim. When I am referred out, it is usually paid for my Medicare then Tricare, which is a portion of the Medicare approved amount. Doctors always bill more than Medicare allows.

[Ship]

So even more pharmacies dropped after the 1st of the year. Back in October my pharmacy dropped off so I switched to one of the only other ones in town and now they are off the list. Big chain for me now. CVS I guess. Was trying to stay with the smaller independently owned pharmacy but that is no longer a choice. What I am not clear on is it these pharmacies dropping Tricare or Tricare dropping them? I don't know.

[n2ratfishin]

Humana or Healthnet manage Tri-Care depending on your region. They manage Tri-Care under a Memorandum of Understanding they bid on and agree to with The Defense Health Agency under The Assistant Secretary of Defense.

[wwc3]

VA pharmacy just sends mine in the mail !!!

[wmitch2]

VA pharmacy just sends mine in the mail !!!

Yep, mine too !! AND since I'm at 90% disabled I have no Co-Pay too ! I'd say go see if you can qualify for VA benefits !!!

[Ship]

Yeah I retired in 2005 and I’m not claiming disability. Express scripts seems fine for some things but occasionally we need something asap and get the run around. It use to be so much easier. For years my doctor’s office was co-located with our pharmacy. Is what it is. Tricare is cheap but very limited services where I live.