Tricare, Prescription Costs Set to Increase for Retirees in 2022

Tricare, Prescription Costs Set to Increase for Retirees in 2022

Tricare beneficiaries are facing an increase in pharmacy co-pays and enrollment fees in 2022 according to a recent report from the Federal Register.

Military families and retirees who have used Tricare mail-order delivery services can expect higher copayments. Also, younger retirees without access to Medicare or Tricare for Life are more likely to pay more for enrollment in health insurance and can expect higher enrollment fees, although the exact amount has yet to be determined.

Patients who are eligible can still save some money by using military pharmacies which do not charge a copay. They can also save money by using Tricare's mail-order pharmacy.

Servicemembers who were medically retired before Jan. 1, 2018, their families who are enrolled in Tricare Prime, and surviving family members of sponsors who died while serving on active duty, are all exempt from the price hikes as long as they remain in the health program.

In the Tricare Pharmacy Program Overview, Tricare groups medications by their efficiency in treating patients and their cost-effectiveness relative to other drugs of the same class. Generic formulary drugs have the lowest prices and are widely available. Formulary drugs that are branded and non-formulary drugs follow. These three categories will all see increased costs. Pharmacy costs might differ from one another.

At retail network pharmacies, you may only order some brand-name maintenance medications twice. Long-term conditions are treated with these medications. Using home delivery or military pharmacies is required after the second refill. Filling short-term use medications at network retail pharmacies are exempt from this rule.

You will be responsible for 50% of the costs of your covered drugs after you have met your point-of-service deductible with a Tricare Prime plan. Pharmacy costs for non-network projects are as follows:

  • After meeting your deductible, generic formulary drugs will cost $38 (increased from $33). Brand-name formulary drugs will cost you 20% of the total cost.

  • After you meet your annual deductible, you will be responsible for paying 68 dollars (up from 60 dollars) for non-formulary drugs.

When possible, military pharmacies will be your cheapest option. Military pharmacies don’t charge for generic or brand-name drugs that are covered by the program.