Tricare for Life Users Surprised by Drug Cost Increase

[RV_]

I usually get mt drugs form the base here. But I had one not on the formulary in January and filled my prescription off base for the first time in years!

Excerpt:

"Over the last few weeks, I have heard from many Tricare for Life beneficiaries caught off guard by the recent increase to pharmacy costs, including a change that moved drugs that had been completely free to a charge of $7 for a 90-day supply.

Drug prices increased Feb. 1 for all Tricare users, including retirees over 65 on Tricare for Life.

 

A 90-day supply of generic drugs received through the system's Express Scripts mail-order pharmacy went from free to $7. Co-pays on brand-name drugs received through the mail went from $20 to $24 and from $49 to $53 for non-formulary drugs.

For prescriptions filled at retail pharmacies, a 30-day supply for generic drugs increased from $10 to $11, while brand-name drugs went from $24 to $28; non-formulary drugs went from $49 to $53.

Drugs filled at a military treatment facility continue to be free.

Drug costs typically increase slightly every Feb. 1. But the increase from free to $7 for generics received by mail came as a surprise for many users on Tricare for Life, according to feedback I've received by email. Many users had read that changes to Tricare happening Jan. 1 didn't really impact them.

So what caused the confusion? Too many changes at once.

Tricare for Life users really are not impacted by the big changes to Tricare that hit Jan. 1 beyond this minor calendar shift that most users won't even notice.

What was poorly communicated, perhaps, was that the pharmacy increases were completely separate from the Jan. 1 updates. Like all pharmacy cost changes in years past, those updates do impact Tricare for Life users."

More Links and info here:

https://www.military.com/militaryadvantage/2018/02/22/tricare-life-users-surprised-drug-cost-increase.html

 

[Chalkie]

Yes, well, it caught us by surprise, BUT, our medical costs are still far less than others face.

 

[RV_]

I hear ya. But some older retirees like my FIL with no no VA rating could hurt them. But I agree, we sure did, and earned it. I wasn't complaining! Just passing along the new rates.

[Chalkie]

Could you explain what having or not having a VA rating has to do with Tricare for Life?

 

[Biker56]

Quote

  Prescriptions filled at retail pharmacies, a 30-day supply for generic drugs increased from $10 to $11

Check Walmart if your generic is on their $4 for 30 days list or $10 for 90 days.

[DJW]

We knew it was coming.  RV had posted earlier about the changes that were coming for Tricare and Tricare for Life.  It was also covered in the letter we received outlining the changes that were coming after Jan 1st.  I thought the change from free to $7 was a little steep.  Just a reminder make sure if you get a new prescription that the Doc writes it for a 90 day supply not 30 days.  Linda's eye Doc wrote her a new one for eye drops and did not indicate a 90 day supply and it started out at $7 a month.  The prescription has now been changed to a 90 day supply for a single cost of $7.  I still get all my prescriptions from the VA and they are still free so it is pretty much a wash.

Dennis

[Chalkie]

8 hours ago, Biker56 said:

Check Walmart if your generic is on their $4 for 30 days list or $10 for 90 days.

In which case the $7 fee for a generic for 90 days is still less.

 

[RV_]

Chalkie,

My recently deceased FIL was Army and a member of MacArthur's Headquarters Honor guard when he was military governor of Japan through Vietnam (He was stationed in Thailand) and retired in 1998. He crossed over to Air Force after his stint in the Army. He was too proud to ask for a disability rating and his retirement check was not enough to live on. Fortunately he did make wise investments, worked a second career at the regional airport, and HVAC technician. There wasn't much call for aircraft and personnel parachute packers. There are fellow retiree couples living on just one spouses military retirement for whatever time they can't or don't work until they can collect Social security as well. If we had a house note and car notes we couldn't live on retirement and SS. We bought out truck and fiver cash and made it on just my retirement. Of course that was 1997-2003 and diesel was about $1-$1.50 a gallon here.

I did go back to work for five years, 2005-2009 after I retired from the AF, and after we came off the road to care for them in late 2003.

BTW, he had his Honor Guard certificate and an issue of time Magazine in excellent condition from that same tour of his in MacArthur's Japanese HQ as a personal guard. He had it in the attic in a ratty old frame. We had it reframed professionally at Michael's. THen this year we found out it was worth quite a lot more than ewe thought with an original MacArthur signature. We framed it for family, not selling. It came out great!

 

[Chalkie]

On 2/26/2018 at 8:58 PM, RV_ said:

I hear ya. But some older retirees like my FIL with no no VA rating could hurt them.

RV it sounds as though your FIL had an amazing and highly interesting career. I think I would have loved to meet him. However, in the quote above you mentioned having a VA rating. Your story does not answer my question. Having a VA rating can impact the taxation of your military retirement. As a retiree I have never bothered with the VA for a number of reasons. If there is some advantage, I might consider it, so my question still stands.

On 2/27/2018 at 6:25 AM, Chalkie said:

Could you explain what having or not having a VA rating has to do with Tricare for Life?

 

[Biker56]

15 hours ago, Chalkie said:

In which case the $7 fee for a generic for 90 days is still less.

 

For prescriptions filled at retail pharmacies, a 30-day supply for generic drugs increased from $10 to $11

$7 is for Express Scripts mail-order 90 days

Two different ways on getting them. $7 for 90 days mail or at pharmacies for $33 for 90 days.

If on Walmart $4 list then $12 for 90 days.
Your choice.

Mail order wouidn't work for me or probably some others. As I travel for 5 months in the summer and never receive any mail.
All my bills, bank accounts, CC accounts are paper less.
 

[NDBirdman]

3 hours ago, Chalkie said:

 Having a VA rating can impact the taxation of your military retirement. As a retiree I have never bothered with the VA for a number of reasons. If there is some advantage, I might consider it, so my question still stands.

I think the higher the rating, the more the advantage.  Myself, I pay very little property taxes, $300 out of 3K annual, no tag/registration fees on 2 vehicles, no sales/reg. taxes on one new vehicle per year, all meds/medical are free to me, wife's meds (not yet on tri-care for life), never pays more than (I think, she pays it) $3 per refil although she can only get one month at a time.  I believe when she goes on TFL, it becomes secondary to medicare which if I remember right, will cover almost all cost of medical/perscrips?  Some of this is because the state of ND offers this.  The VA compensation I receive is all tax free, no fed or local taxation.  That makes a huge difference.  It does not make a difference on my other retirements/incomes.  I still get nailed on that (not complaining, I pay my part).  To answer your question, does it impact your military retirement, again, it depends on what rating you get.  Don't quote me, it's been a while, but if you receive under (50% ?), what you gain from the VA is removed from your military retirement, but you receive the VA portion tax free.  For example, if you receive a rating that gives you $400 or so, you lose that from your retired pay that is taxed, then get that from the VA ($400) tax free.  Best is to not quite/follow what I said and talk to a VA rep.

Saying that, we just returned from a small town in Indiana.  When we showed up, did the hug thing, etc with family, we were told everyone had type A flu, the bad one.  We went to a clinic immediately to get checked out/preventive meds.  When all  was said and done, they said sorry, we don't accept Tric-care (west, our coverage).  Nor will the VA pay it as I did not go to their hospital (none close to where we were).  I had to pay for everything out of pocket, that hurt.  I may submit the bill to them after we receive all of them, hope they pay but not counting on it.

[Chalkie]

3 hours ago, NDBirdman said:

We went to a clinic immediately to get checked out/preventive meds.  When all  was said and done, they said sorry, we don't accept Tric-care (west, our coverage).

Is this Tricare for LIFE? I ask because you have to have Medicare in order to have Tricare for Life and Medicare is your Primary coverage, not Tricare. We have never had a problem anywhere as long as they accept Medicare. 

Oh, and yes, I was thinking about ExpressScripts. 

[NDBirdman]

1 hour ago, Chalkie said:

Is this Tricare for LIFE? I ask because you have to have Medicare in order to have Tricare for Life and Medicare is your Primary coverage, not Tricare. We have never had a problem anywhere as long as they accept Medicare. 

Oh, and yes, I was thinking about ExpressScripts. 

I have 4 years before I go on medicare.  My wife is about to turn 65, I know we have to start paying medicare part (A?) for her to have it (TFL).  I think the rules are wrong, or screwed up when I have 100% VA for life but still have to pay the monthly for part a.  But for my wife to have it, I have to pay for something I will never use.  I guess medicare might have paid for our meds/visit but not quite there yet.  This whole thing has me confused.

 

[Chalkie]

1 hour ago, NDBirdman said:

I have 4 years before I go on medicare.  My wife is about to turn 65, I know we have to start paying medicare part (A?) for her to have it (TFL).  I think the rules are wrong, or screwed up when I have 100% VA for life but still have to pay the monthly for part a.  But for my wife to have it, I have to pay for something I will never use.  I guess medicare might have paid for our meds/visit but not quite there yet.  This whole thing has me confused.

 

It is Medicare Part B that you pay for, Part A is free. You also have to have Part B to be eligible for Tricare for Life. 

 

[DJW]

NDBirdman

I am in the same boat.  But think of it this way.   If you are traveling and have a medical emergency and there is no VA close then you are covered by your Medicare part B and Tricare for Life.  TFL requires that the sponsor be signed up the Medicare Part B for the spouse to be covered, however if you die she/he retains it.  Yes it is a rub to pay for something you will not use often but if you do need it the $1656 a year you pay for Medicare Part B will hurt way less than if you did not have it and needed it.  As far as getting reimbursed by the VA for the flu med's.  Save the .45 cent stamp you will be that much more ahead.

Dennis

[RV_]

23 hours ago, RV_ said:

He was too proud to ask for a disability rating and his retirement check was not enough to live on. Fortunately he did make wise investments, worked a second career at the regional

Chalkie ^^^^^^^^^^

Sorry it was buried in there.

[RV_]

ND Birdman I was confused too and just turned 65 this past year. It was automatic they sent me a notice and I just accpeted and pay suddenly ~ $130 a month for me, and my younger wife (2 yrs) is Tricare but we only pay her co-pays and initial deductible if she does go to the doc, which we both do for annuals and preventives like the Dermatologist every six months to year. We were Standard and she is now Select until 2019 when she is TFL too.

I have a question I can't find easily. Does she still have to pay the Select deductible or is my TFL covering? When we both are TFL I assume I pay one Part B not two unless I am reading it wrong.

Good info guys.

[RV_]

But . . .

"While running for president in 2016, Trump pledged to leave popular benefit programs such as Medicare and Social Security untouched, but his new budget proposal would reduce Medicare spending by $236 billion over the next 10 years.

The White House argued, however, that the reduced spending would come through reforms to the government health insurance program for the elderly, not benefit cuts."

However the article goes on to speculate:

"There is little chance of those cuts becoming real, as presidential budgets are rarely enacted by the U.S. Congress, which controls federal purse strings. Instead, the budget allows the White House to lay out its priorities for the year.

Still, the proposed cuts drew a rebuke from the top Democrat on the House of Representatives Budget Committee, John Yarmuth.

”These cuts to critical federal investments are so extreme they can only reflect a disdain for working families and a total lack of vision for a stronger society,” Yarmuth said in a statement."

Source from 16 days ago: https://www.reuters.com/article/us-usa-budget/trump-budget-seeks-cuts-to-domestic-programs-medicare-favors-military-and-wall-idUSKBN1FW0BL

[NDBirdman]

27 minutes ago, RV_ said:

? When we both are TFL I assume I pay one Part B not two unless I am reading it wrong.

I called a guy I know in the same boat.  He and wife are both over 65.  They both are paying for part b, so they are getting hit twice.  He is also 100% VA and is happy about paying twice too. 

[RV_]

Dang! Our promised medical for life, pharmacy, and dental are all flying out the window further because we have the fewest people in congress, and the Judicial, who have served in the military than ever before.

[Chalkie]

11 hours ago, RV_ said:

Chalkie ^^^^^^^^^^

Sorry it was buried in there.

I got all that, but that still does not seem to have anything at all to do with Tricare for Life. How does a VA rating impact Tricare for Life? Not the tax breaks, or anything else, just the Tricare for Life program?

[Chalkie]

9 hours ago, RV_ said:

Dang! Our promised medical for life, pharmacy, and dental are all flying out the window further because we have the fewest people in congress, and the Judicial, who have served in the military than ever before.

Not to put too fine a point on this, and I was disappointed too, but those promises were never codified by law so no matter what some recruiter might have said, they are empty promises. Read this article.

[DJW]

RV

Yes as you now know you both pay the Medicare Part B.  We went from getting everything covered by the VA for me and the DW paying $237 a year for Tricare Prime to now paying $3,300 a year for 2 Medicare Part B's.  I still get everything from the VA and it is soon to be 3 years having Medicare Part B that I have never used once.  Now that being said I believe the VA bills Medicare and TFL.  I was told yesterday that I have bladder cancer and the VA is picking up the tab for outside care because the VA does not have a Urologist on staff at the local VA hospital.  I am guessing that I could not cover the cost out of pocket for $1,656 or even close so I think it is money well spent.

Dennis

[NDBirdman]

2 hours ago, DJW said:

  I was told yesterday that I have bladder cancer and the VA is picking up the tab for outside care because the VA does not have a Urologist on staff at the local VA hospital.  I am guessing that I could not cover the cost out of pocket for $1,656 or even close so I think it is money well spent.

Dennis

I am sorry to hear that.  I hope you get a good Dr/Hosp. that can cure it.  As for covering the cost, you are right.  That is a small price to pay for the coverage you are (going) to get.  My nephew just went through cancer treatment, was cured, but the bill came to well over 3.6 mil.  I do believe that VA bills tri-care for services.

[DJW]

NDBirdman

Thanks for the kind words.  Great Doctor and Hospital.  My older brother who is 3 years older just went through this last  Jun/Jul and he has a 100% VA rating.  I am using the same Doc that my  brother and a PHD Doctor friend of mine did.    Both had excellent results.

Dennis