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CHRISTIANNE WITTEN: 
Good afternoon, good morning,
and good
15
00:00:04,410 --> 00:00:07,720
evening, everyone. My name is Christiane Witten,
and I'm the
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00:00:07,720 --> 00:00:11,460
Chief of Internal Communications
here at the Defense Health
17
00:00:11,460 --> 00:00:15,040
Agency, and I'm pleased 
to welcome you to today's webinar,
18
00:00:15,040 --> 00:00:18,570
"Using Your TRICARE Pharmacy Benefits." This
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00:00:18,570 --> 00:00:22,370
webinar will give you an overview
of the TRICARE Pharmacy Program, and
20
00:00:22,370 --> 00:00:26,260
you'll learn about your options
for getting and managing your
21
00:00:26,260 --> 00:00:29,780
prescriptions.
We'll also provide information
22
00:00:29,780 --> 00:00:31,760
about recent changes to the process
23
00:00:31,830 --> 00:00:35,070
for getting specialty drugs
through the TRICARE pharmacy
24
00:00:35,070 --> 00:00:38,980
network.
But before we dive into today's
25
00:00:38,980 --> 00:00:42,660
discussion, we did want to
again acknowledge a reported cyber-
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00:00:42,660 --> 00:00:45,750
attack on the nation's
largest commercial prescription
27
00:00:45,750 --> 00:00:49,180
processor known as Change Healthcare or
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00:00:49,180 --> 00:00:52,480
CHC, which continues to
29
00:00:52,480 --> 00:00:55,720
affect military clinics and hospitals
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00:00:55,720 --> 00:00:59,190
worldwide.
On February 21, 2024,
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00:00:59,190 --> 00:01:02,290
Change Healthcare
disconnected its systems to
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00:01:02,290 --> 00:01:05,560
protect patient information.
This has impacted
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00:01:05,560 --> 00:01:09,080
all military pharmacies worldwide
and some retail
34
00:01:09,080 --> 00:01:09,530
pharmacies.
35
00:01:09,620 --> 00:01:12,890
Nationally, as of today,
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00:01:12,890 --> 00:01:16,240
March 14, military clinics
and hospitals will continue
37
00:01:16,240 --> 00:01:19,680
to provide prescriptions
through manual procedures
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00:01:19,680 --> 00:01:23,190
until this issue is resolved.
Military pharmacies
39
00:01:23,190 --> 00:01:26,910
will give priority to 
urgent prescriptions, followed
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00:01:26,910 --> 00:01:30,240
by routine prescriptions.
Each military hospital and
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00:01:30,240 --> 00:01:33,290
clinic will continue 
to offer pharmacy options
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00:01:33,290 --> 00:01:35,620
based on their local manning and resources.
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00:01:36,380 --> 00:01:39,830
Please be patient while pharmacies
may take longer than usual to
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00:01:39,830 --> 00:01:43,080
safely fill prescription
45
00:01:43,080 --> 00:01:46,760
needs. It's unknown at this time
when this will be resolved, but
46
00:01:46,760 --> 00:01:49,780
beneficiaries should contact
their local military clinic or
47
00:01:49,780 --> 00:01:52,880
retail pharmacy for the latest local updates
48
00:01:52,880 --> 00:01:54,570
on getting prescriptions filled.
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00:01:55,220 --> 00:01:58,480
It's important to note that
TRICARE home delivery program
50
00:01:58,480 --> 00:02:01,980
was not affected by CHC
51
00:02:01,980 --> 00:02:05,760
going offline.
We've posted this information in our TRICARE
52
00:02:05,760 --> 00:02:09,390
Newsroomm and you'll also find the link 
in the Q&A section of this
53
00:02:09,390 --> 00:02:11,430
livestream for your reference.
54
00:02:12,770 --> 00:02:15,900
With that, we're excited to welcome
our presenter for
55
00:02:15,900 --> 00:02:19,150
today, Miss Tess Wolstenholme, senior
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00:02:19,150 --> 00:02:22,520
benefits service analyst for 
Healthcare Operations in
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00:02:22,520 --> 00:02:25,740
our Pharmacy Operations Division
here at the Defense
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00:02:25,740 --> 00:02:28,580
Health Agency.
Tess, I'll turn things over to you.
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00:02:30,110 --> 00:02:33,240
TESS WOLSTENHOLME:
Thank you, Christianne.
Good day to all
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00:02:33,240 --> 00:02:36,300
and thank you for joining in
today's webinar regarding
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00:02:36,300 --> 00:02:39,360
TRICARE pharmacy benefits.
As stated earlier, I am
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00:02:39,360 --> 00:02:42,390
Tess Wolstenholme, senior benefits analyst
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00:02:42,390 --> 00:02:45,500
at the Pharmacy Operations Division
here at the Defense
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00:02:45,500 --> 00:02:48,960
Health Agency. I am excited
to have you here today and
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00:02:48,960 --> 00:02:52,320
I look forward to sharing an overview
of TRICARE pharmacy benefits
66
00:02:52,320 --> 00:02:55,510
with you today. We will review
67
00:02:55,510 --> 00:02:59,640
options for filling your prescriptions,
including maintenance medications, and related
68
00:02:59,640 --> 00:02:59,960
costs.
69
00:03:01,160 --> 00:03:04,860
We will also review 
recent changes to filling specialty
70
00:03:04,860 --> 00:03:08,340
prescriptions and other resources
that are available to help you make the most
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00:03:08,340 --> 00:03:11,340
of your pharmacy benefits.
Next slide, please.
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00:03:16,450 --> 00:03:19,700
The TRICARE Pharmacy Program
is available to
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00:03:19,700 --> 00:03:21,320
all TRICARE-eligible beneficiaries.
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00:03:23,170 --> 00:03:26,430
This includes beneficiaries
entitled to Medicare
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00:03:26,430 --> 00:03:29,610
Part A and B based on their
76
00:03:29,610 --> 00:03:32,750
age. To be eligible for
TRICARE For Life, also known
77
00:03:32,750 --> 00:03:36,090
as TFL,
you must have Medicare Part A
78
00:03:36,090 --> 00:03:39,590
and Medicare Part B.
You do not need Medicare
79
00:03:39,590 --> 00:03:43,090
Part D to have TFL. That's
80
00:03:43,090 --> 00:03:46,290
because TFL has the same
prescription drug coverage
81
00:03:46,290 --> 00:03:47,430
as other TRICARE health plans.
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00:03:49,010 --> 00:03:52,780
Express Scripts by Evernorth,
formerly known as Express
83
00:03:52,780 --> 00:03:56,130
Scripts Incorporated (ESI), manages
84
00:03:56,130 --> 00:03:59,400
your pharmacy benefits,
including home
85
00:03:59,400 --> 00:04:02,300
delivery, retail pharmacies,
and specialty pharmacy services.
86
00:04:04,340 --> 00:04:07,900
The TRICARE Pharmacy Program
provides coverage to
87
00:04:07,900 --> 00:04:11,320
all TRICARE beneficiaries,
including all active duty service
88
00:04:11,320 --> 00:04:11,670
members,
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00:04:12,500 --> 00:04:14,230
active duty family members,
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00:04:14,870 --> 00:04:17,880
National Guard and Reserve members and their
91
00:04:17,880 --> 00:04:18,200
family members,
92
00:04:18,870 --> 00:04:21,020
and retirees and their family members.
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00:04:21,820 --> 00:04:24,990
All TRICARE beneficiaries have the
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00:04:24,990 --> 00:04:28,280
same prescription coverage,
regardless of your TRICARE health
95
00:04:28,280 --> 00:04:31,580
plan, such as TRICARE Prime, TRICARE
96
00:04:31,580 --> 00:04:34,690
Select, and TRICARE For Life.
However, if
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00:04:34,690 --> 00:04:37,820
you are enrolled under 
the US Family Health Plan, you
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00:04:37,820 --> 00:04:41,140
have separate pharmacy coverage.
This means
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00:04:41,140 --> 00:04:44,540
that you must follow the rules of
their prescription program
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00:04:44,540 --> 00:04:46,270
and you have different pharmacy options.
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00:04:46,970 --> 00:04:50,160
It is essential that you keep the
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00:04:50,160 --> 00:04:53,250
Defense Enrollment Eligibility Reporting System,
also known
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00:04:53,250 --> 00:04:53,990
as DEERS,
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00:04:54,690 --> 00:04:57,850
up to date.
This allows you and your family
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00:04:57,850 --> 00:05:01,600
members to use
your TRICARE pharmacy benefits.
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00:05:01,600 --> 00:05:02,130
Next slide, please.
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00:05:03,980 --> 00:05:04,710
108
00:05:05,920 --> 00:05:09,080
There are four TRICARE pharmacy
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00:05:09,080 --> 00:05:12,310
options: military pharmacies, home
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00:05:12,310 --> 00:05:14,910
delivery, network pharmacies,
and non-network pharmacies.
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00:05:16,170 --> 00:05:19,300
Each option is available worldwide,
but there
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00:05:19,300 --> 00:05:22,540
are some limits overseas.
Your first option
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00:05:22,540 --> 00:05:23,360
is military pharmacies.
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00:05:25,110 --> 00:05:28,240
Military pharmacies stock 
drugs on the Basic Core
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00:05:28,240 --> 00:05:31,400
Formulary, as well as some brand-name
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00:05:31,400 --> 00:05:33,180
maintenance drugs that are
on the Uniform Formulary.
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00:05:34,190 --> 00:05:37,200
You can also get up to 
90 days’ supply for most drugs.
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00:05:37,990 --> 00:05:41,120
Make sure to check
the TRICARE Formulary website
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00:05:41,120 --> 00:05:42,900
to see if your prescription is covered.
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00:05:45,560 --> 00:05:48,780
Your second option is TRICARE Home
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00:05:48,780 --> 00:05:51,800
Delivery administered by Express Scripts.
If you take
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00:05:51,800 --> 00:05:54,900
medication on a regular, ongoing
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00:05:54,900 --> 00:05:58,310
basis, you can get up to 90-day supply
and have it delivered
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00:05:58,310 --> 00:06:00,030
right to your door with home delivery.
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00:06:01,910 --> 00:06:05,380
Your second option is 
TRICARE home delivery administered
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00:06:05,380 --> 00:06:08,960
by Express Scripts.
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00:06:08,960 --> 00:06:09,620

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00:06:11,070 --> 00:06:14,320
Please note it is recommended that
you have a 30-day
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00:06:14,320 --> 00:06:17,370
supply of medication on hand
before your first
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00:06:17,370 --> 00:06:21,780
home delivery order.
You can register for home delivery online or
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00:06:21,780 --> 00:06:25,190
by phone by calling 877-
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00:06:25,930 --> 00:06:29,060
363-13
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00:06:29,060 --> 0P0:06:30,390
03. I repeat,
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00:06:31,310 --> 00:06:32,460
877-
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00:06:33,320 --> 00:06:36,410
363-1303.
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00:06:36,410 --> 00:06:39,790
Your provider will need 
to send your prescriptions
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00:06:39,790 --> 00:06:43,840
to Express Scripts to be filled.
For faster service, you can
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00:06:43,840 --> 00:06:47,590
ask your doctor to
submit your prescription electronically
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00:06:47,590 --> 00:06:48,440
via ePrescribe.
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00:06:50,560 --> 00:06:54,830
Your third pharmacy option is
retail network pharmacies. There are
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00:06:54,830 --> 00:06:58,030
more than 41,000 locations in the U.S.
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00:06:58,030 --> 00:07:01,130
and the U.S. territories of Guam,
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00:07:01,130 --> 00:07:04,440
Puerto Rico, the U.S. Virgin Islands, and the Northern
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00:07:04,440 --> 00:07:05,130
Mariana Islands.
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00:07:05,770 --> 00:07:08,700
Filling your prescriptions at
a network pharmacy is easy.
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00:07:09,470 --> 00:07:13,480
Ask your provider to send 
your prescription electronically or
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00:07:13,480 --> 00:07:16,500
hand carry your written prescription
to the pharmacy.
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00:07:16,500 --> 00:07:19,850
You may be required to show
your military ID card to
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00:07:19,850 --> 00:07:20,120
verify eligibility.
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00:07:22,430 --> 00:07:25,850
Your last option is
non-network pharmacies. At
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00:07:25,850 --> 00:07:29,010
non-network pharmacies,
you will have to pay full
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00:07:29,010 --> 00:07:32,000
price for your prescription drugs
and file a claim for reimbursement.
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00:07:32,940 --> 00:07:35,170
Reimbursements are subject to deductibles,
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00:07:35,920 --> 00:07:39,040
out-of-pocket network cost-shares,
and copayments.
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00:07:39,730 --> 00:07:42,770
All deductibles must be met before you
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00:07:42,770 --> 00:07:43,630
can be reimbursed.
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00:07:44,500 --> 00:07:45,510
Next slide, please.
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00:07:49,600 --> 00:07:52,740
Now that we have reviewed 
your pharmacy options, let’s
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00:07:52,740 --> 00:07:54,000
review some pharmacy costs.
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00:07:54,680 --> 00:07:59,280
Active duty pays nothing
for covered drugs from military
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00:07:59,280 --> 00:08:01,320
pharmacies, retail network pharmacies,
and home delivery.
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00:08:03,480 --> 00:08:06,750
The cost of TRICARE pharmacy depends on the type of
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00:08:06,750 --> 00:08:08,860
the medication and the duration of supply.
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00:08:09,670 --> 00:08:13,360
Active duty service members have 0 copay for
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00:08:13,360 --> 00:08:14,630
covered drugs at any pharmacy.
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00:08:16,520 --> 00:08:19,740
For all other beneficiaries,
copayments apply
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00:08:19,740 --> 00:08:22,900
to receive up to 90-day supply of
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00:08:22,900 --> 00:08:26,640
generic, brand name, 
and non-formulary medications.
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00:08:28,060 --> 00:08:31,520
If you get a prescription
from a non-network pharmacy, you
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00:08:31,520 --> 00:08:34,640
will pay the full cost of the drug up front; then
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00:08:34,640 --> 00:08:36,570
you can file claim for reimbursement.
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00:08:37,210 --> 00:08:40,310
If you fill a prescription for a drug TRICARE
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00:08:40,310 --> 00:08:43,320
does not cover,
you will pay the full cost of
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00:08:43,320 --> 00:08:43,870
the drug.
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00:08:45,140 --> 00:08:46,230
Next slide, please.
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00:08:48,070 --> 00:08:48,550
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00:08:51,150 --> 00:08:54,350
This slide shows copayments
for non-active duty service
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00:08:54,350 --> 00:08:54,660
members.
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00:08:55,350 --> 00:08:58,530
The copayments for generic formulary drugs
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00:08:58,530 --> 00:09:00,960
range from $13 to $16.
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00:09:01,670 --> 00:09:04,910
For brand name formulary drugs,
your copayment
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00:09:04,910 --> 00:09:08,010
will range from $38 to $43.
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00:09:08,010 --> 00:09:08,260

184
00:09:09,460 --> 00:09:12,670
Non-formulary drugs,
your copayment will be up
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00:09:12,670 --> 00:09:13,930
to $76.
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00:09:15,000 --> 00:09:18,190
Keep in mind that
the copayments listed for home
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00:09:18,190 --> 00:09:21,370
delivery are for 90-day supply for
188
00:09:21,370 --> 00:09:24,890
your prescription,
and the copayments listed for retail network
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00:09:24,890 --> 00:09:28,550
pharmacies are for a 30-day supply
of your prescription.
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00:09:28,550 --> 00:09:31,170
This may influence where you
decide to fill your prescription.
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00:09:32,010 --> 00:09:35,250
In some cases, you may be able to get a
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00:09:35,250 --> 00:09:39,040
90-day supply of your prescription
at a retail network pharmacy
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00:09:39,040 --> 00:09:42,190
for the cost of
3 retail network pharmacy copayments.
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00:09:44,680 --> 00:09:48,210
Please note that copayments for survivors of
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00:09:48,210 --> 00:09:51,370
active duty service members
and medically retired service
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00:09:51,370 --> 00:09:55,070
members and their family members
have not changed
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00:09:55,070 --> 00:09:56,110
in 2024.
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00:09:58,630 --> 00:10:02,420
You will see your pharmacy costs
using the TRICARE Compare
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00:10:02,420 --> 00:10:05,770
Cost Tool at TRICARE.mil/costs.
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00:10:07,510 --> 00:10:08,550
Next slide, please.
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00:10:13,810 --> 00:10:17,170
Any drug you take regularly for chronic
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00:10:17,170 --> 00:10:20,430
conditions, such as diabetes,
high blood pressure,
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00:10:20,430 --> 00:10:23,100
thyroid, etc.,
is considered a maintenance medication.
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00:10:25,450 --> 00:10:28,500
There are some maintenance drugs
that you must fill through
205
00:10:28,500 --> 00:10:31,550
TRICARE home delivery
or at a military pharmacy.
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00:10:33,660 --> 00:10:36,820
Be sure to go to TRICARE.mil
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00:10:36,820 --> 00:10:39,880
/FillPrescriptions to see if your drug is on
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00:10:39,880 --> 00:10:40,300
the list.
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00:10:42,140 --> 00:10:45,480
Exception to the rule: If you use
210
00:10:45,480 --> 00:10:48,720
generic maintenance drugs,
you are exempt from this rule
211
00:10:48,720 --> 00:10:52,040
and you can continue
to fill your prescription at a
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00:10:52,040 --> 00:10:52,380
network pharmacy.
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00:10:54,910 --> 00:10:58,020
Also, as a reminder,
the first time you fill
214
00:10:58,020 --> 00:11:01,440
your prescription at a retail pharmacy,
Express Scripts will
215
00:11:01,440 --> 00:11:04,450
send you a letter telling you
that you need to switch
216
00:11:04,450 --> 00:11:08,300
your maintenance prescription
to mail order or military pharmacy.
217
00:11:10,170 --> 00:11:12,590
Express Scripts will send you another letter
218
00:11:13,450 --> 00:11:16,890
reminding you to switch your prescription
to mail order
219
00:11:16,890 --> 00:11:20,070
or military pharmacy
the second time you fill your
220
00:11:20,070 --> 00:11:21,200
prescription at a retail pharmacy.
221
00:11:22,210 --> 00:11:25,220
The third time you fill your prescription at a
222
00:11:25,220 --> 00:11:28,530
retail pharmacy,
you will be responsible for the
223
00:11:28,530 --> 00:11:30,060
full cost of the medication.
224
00:11:33,690 --> 00:11:34,620
Next slide, please.
225
00:11:36,900 --> 00:11:37,230

226
00:11:39,100 --> 00:11:42,220
Now let's talk about 
filling prescriptions for specialty
227
00:11:42,220 --> 00:11:42,620
drugs.
228
00:11:44,360 --> 00:11:48,190
Specialty drugs are usually self-administered,
229
00:11:48,190 --> 00:11:50,680
high-cost injectable or oral drugs.
230
00:11:52,870 --> 00:11:55,620
They can require clinical training to administer.
231
00:11:57,600 --> 00:12:00,910
They treat chronic conditions such as
232
00:12:00,910 --> 00:12:04,130
cancer, multiple sclerosis,
rheumatoid arthritis,
233
00:12:04,130 --> 00:12:04,740
and hepatitis C.
234
00:12:06,900 --> 00:12:09,110
They may need special storage and handling
235
00:12:10,000 --> 00:12:13,320
and they are not available
from many retail pharmacies.
236
00:12:15,910 --> 00:12:19,010
As of March 1, 2024,
237
00:12:19,010 --> 00:12:22,420
Accredo will provide specialty pharmacy services
238
00:12:22,420 --> 00:12:25,680
when you fill an eligible specialty medication at
239
00:12:25,680 --> 00:12:26,630
TRICARE home delivery.
240
00:12:28,780 --> 00:12:32,000
If you fill
eligible specialty drug prescriptions
241
00:12:32,000 --> 00:12:33,290
through TRICARE home delivery,
242
00:12:33,960 --> 00:12:36,400
Accredo will give you access to the following:
243
00:12:39,120 --> 00:12:42,550
Expert advice from 
specialty trained pharmacists and
244
00:12:42,550 --> 00:12:45,990
nurses available 24 hours a
245
00:12:45,990 --> 00:12:46,940
a day, 7 days a week.
246
00:12:49,030 --> 00:12:52,090
Receive condition-specific support
from clinicians.
247
00:12:54,250 --> 00:12:57,610
Schedule delivery of your specialty drugs to your
248
00:12:57,610 --> 00:13:00,710
home or office
on the day that works for you at
249
00:13:00,710 --> 00:13:02,010
no additional cost.
250
00:13:02,960 --> 00:13:06,690
And manage your specialty medications
and set refill reminders.
251
00:13:08,430 --> 00:13:09,430
Next slide, please.
252
00:13:12,770 --> 00:13:15,970
TRICARE’s in-network
for specialty drugs includes:
253
00:13:16,860 --> 00:13:18,890
TRICARE Pharmacy Home Delivery,
254
00:13:19,680 --> 00:13:22,710
including specialty pharmacy services
255
00:13:22,710 --> 00:13:22,860
by Accredo.
256
00:13:24,190 --> 00:13:27,680
An in-network retail pharmacy -- This
257
00:13:27,680 --> 00:13:31,650
includes Accredo, a special pharmacy
serving TRICARE patients with
258
00:13:31,650 --> 00:13:33,110
complex and chronic health conditions.
259
00:13:34,070 --> 00:13:37,540
A military pharmacy -- You can check with your
260
00:13:37,540 --> 00:13:41,030
local military pharmacy
to see if they stock your medication
261
00:13:41,030 --> 00:13:42,780
and if so, how to switch.
262
00:13:43,960 --> 00:13:47,020
As a reminder, once again, the first
263
00:13:47,020 --> 00:13:50,070
and second time you
fill your specialty drugs at a
264
00:13:50,070 --> 00:13:53,650
retail pharmacy, Express Scripts
will send you a letter telling
265
00:13:53,650 --> 00:13:56,830
you to switch your prescription to mail order
266
00:13:56,830 --> 00:14:00,270
or military pharmacy.
The third time, you will
267
00:14:00,270 --> 00:14:03,590
be responsible for the full cost of the
268
00:14:03,590 --> 00:14:06,670
prescription drugs,
except if you are an active duty service member.
269
00:14:08,140 --> 00:14:09,170
Next slide, please.
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00:14:14,300 --> 00:14:17,430
Now we're going to look at some tools
to help you learn
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00:14:17,430 --> 00:14:18,640
more about your prescriptions.
272
00:14:20,480 --> 00:14:24,200
The first tool is
the TRICARE Formulary Search Tool.
273
00:14:24,200 --> 00:14:27,600
This tool helps you
learn about your prescription,
274
00:14:27,600 --> 00:14:30,970
including where you can fill it
and cost and coverage
275
00:14:30,970 --> 00:14:34,120
of your prescriptions.
The tool is available on the
276
00:14:34,120 --> 00:14:36,850
Express Scripts website
at the link provided on the slide.
277
00:14:37,470 --> 00:14:41,260
When you search for your drug,
the TRICARE Formulary Search Tool
278
00:14:41,260 --> 00:14:41,870
can tell you
279
00:14:42,670 --> 00:14:46,230
formulary status—such as generic drug,
280
00:14:46,230 --> 00:14:49,870
brand-name drug, 
non-formulary drug, non-
281
00:14:49,870 --> 00:14:50,100
covered drug;
282
00:14:51,880 --> 00:14:54,960
where the prescription can be filled—like
283
00:14:54,960 --> 00:14:58,200
home delivery, 
local network pharmacy, or
284
00:14:58,200 --> 00:15:00,960
military pharmacy;
and any applicable copayments,
285
00:15:01,950 --> 00:15:05,140
coverage details and limitations—such as
286
00:15:05,140 --> 00:15:08,150
prior authorization and necessity
287
00:15:08,150 --> 00:15:08,560
forms;
288
00:15:09,400 --> 00:15:13,260
information about the drug;
and other medication options.
289
00:15:14,850 --> 00:15:16,070
Next slide, please.
290
00:15:19,530 --> 00:15:22,910
Another useful tool
to know about is the Find
291
00:15:22,910 --> 00:15:26,130
a Pharmacy Tool.
If you'd like to fill your prescription at
292
00:15:26,130 --> 00:15:29,520
a retail network pharmacy,
you can search by
293
00:15:29,520 --> 00:15:31,710
ZIP code to find a pharmacy in your area.
294
00:15:32,400 --> 00:15:35,600
The link also shares information on how
295
00:15:35,600 --> 00:15:38,850
to transfer your prescription to
a local retail pharmacy.
296
00:15:41,390 --> 00:15:44,810
You can get covered vaccines for free
297
00:15:44,810 --> 00:15:48,840
at participating retail network pharmacies
when the vaccine is administered
298
00:15:48,840 --> 00:15:49,630
by a pharmacist.
299
00:15:50,470 --> 00:15:53,680
Contact your pharmacy before you arrive to confirm
300
00:15:53,680 --> 00:15:54,860
the vaccine is available.
301
00:15:56,410 --> 00:15:58,290
Next, slide please.
302
00:16:02,110 --> 00:16:05,410
The Price a Medication Tool shows you
303
00:16:05,410 --> 00:16:08,490
your local cost at 
local network pharmacies and
304
00:16:08,490 --> 00:16:12,080
at home delivery,
so you can easily find the best
305
00:16:12,080 --> 00:16:15,290
value for your prescriptions and,
unlike the Formulary
306
00:16:15,290 --> 00:16:17,470
Search Tool and
the Find a Pharmacy Tool,
307
00:16:18,130 --> 00:16:21,930
the Price a Medication Tool
is only available if you have
308
00:16:21,930 --> 00:16:25,200
an online Express Scripts account
309
00:16:25,200 --> 00:16:28,180
and contains information specific to
your active prescriptions.
310
00:16:29,370 --> 00:16:32,850
If you haven't already,
you can create an Express
311
00:16:32,850 --> 00:16:35,830
Scripts account to easily manage
your pharmacy benefit information.
312
00:16:36,840 --> 00:16:40,160
Once your account is set up and running,
you can
313
00:16:40,160 --> 00:16:41,730
use the Price a Medication Tool.
314
00:16:44,290 --> 00:16:47,360
You can also submit and manage pharmacy claims
315
00:16:47,360 --> 00:16:51,310
all in one place,
review your explanation of benefit statements—or
316
00:16:51,310 --> 00:16:52,020
EOBs—
317
00:16:52,680 --> 00:16:55,240
order and schedule refills, and much more.
318
00:16:56,160 --> 00:16:58,230
If you have an Express Scripts account,
319
00:16:58,890 --> 00:17:01,990
you can also use the Express Scripts
320
00:17:01,990 --> 00:17:05,310
Pharmacy mobile app.
The app makes it easy to
321
00:17:05,310 --> 00:17:08,890
manage your prescriptions anytime,
322
00:17:08,890 --> 00:17:12,400
anywhere. Set up dosage reminders, 
and you will get
323
00:17:12,400 --> 00:17:15,500
daily notifications on your mobile device
when it's time for you to
324
00:17:15,500 --> 00:17:16,310
take your medication.
325
00:17:18,290 --> 00:17:22,090
You can also use the app
to schedule your next
326
00:17:22,090 --> 00:17:25,060
delivery, check refill status,
and track a prescription order.
327
00:17:27,370 --> 00:17:30,590
You can download the app
from the Apple App
328
00:17:30,590 --> 00:17:32,040
Store and the Google Play Store.
329
00:17:33,970 --> 00:17:35,240
Next slide, please.
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00:17:39,210 --> 00:17:42,790
TRICARE pharmacy automatic refills.
If you're
331
00:17:42,790 --> 00:17:45,990
enrolled in automatic refills
through home delivery,
332
00:17:45,990 --> 00:17:47,580
you must approve each refill.
333
00:17:48,550 --> 00:17:51,630
Express Scripts will contact you using your
334
00:17:51,630 --> 00:17:55,650
preference of choice by email, phone, or
335
00:17:55,650 --> 00:17:58,130
text, asking you to approve your refill
before it is shipped.
336
00:17:58,960 --> 00:18:01,170
If you'd like to sign up for automatic refills,
337
00:18:01,880 --> 00:18:04,980
log in to your Express Scripts account
338
00:18:04,980 --> 00:18:06,730
to determine if you are eligible.
339
00:18:07,810 --> 00:18:11,010
If you're eligible,
you can elect to start automatic
340
00:18:11,010 --> 00:18:13,250
refills using TRICARE home delivery.
341
00:18:14,570 --> 00:18:17,760
I will walk you through
how to do that on the next slide.
342
00:18:18,830 --> 00:18:19,940
Next slide please.
343
00:18:23,620 --> 00:18:27,200
So here's how automatic refills work.
Express
344
00:18:27,200 --> 00:18:31,140
Scripts will send reminders
about your refill until your prescription
345
00:18:31,140 --> 00:18:34,410
expires via your preferred communication. Once
346
00:18:34,410 --> 00:18:38,020
again, this will be by text, email,
347
00:18:38,020 --> 00:18:38,360
phone.
348
00:18:39,190 --> 00:18:42,360
You will get refill reminders
until your prescription
349
00:18:42,360 --> 00:18:42,750
expires.
350
00:18:45,760 --> 00:18:48,970
To confirm or decline your refill,
you must log on to
351
00:18:48,970 --> 00:18:52,220
your account online or 
through the Express Scripts
352
00:18:52,220 --> 00:18:54,760
mobile app to receive your next refill or not.
353
00:18:57,110 --> 00:19:00,190
If you decline your next refill,
it will no longer be
354
00:19:00,190 --> 00:19:01,520
in the auto refill program.
355
00:19:02,240 --> 00:19:05,970
If you want to reenroll your prescription in automatic
356
00:19:05,970 --> 00:19:09,940
refills, you can do so,
but you must opt in
357
00:19:09,940 --> 00:19:11,490
again, and you can do this anytime.
358
00:19:14,070 --> 00:19:17,160
Once you've confirmed your refill,
Express Scripts will
359
00:19:17,160 --> 00:19:19,180
let you know when your medication has shipped.
360
00:19:19,850 --> 00:19:23,000
You can also track the shipment
by logging in to
361
00:19:23,000 --> 00:19:23,490
your account.
362
00:19:25,810 --> 00:19:26,840
Next slide, please.
363
00:19:32,790 --> 00:19:36,000
Before we begin answering
some of your questions, I
364
00:19:36,000 --> 00:19:39,090
want to take a moment 
to highlight some helpful resources.
365
00:19:41,570 --> 00:19:44,780
First, here's the contact information for your
366
00:19:44,780 --> 00:19:46,050
TRICARE pharmacy partners.
367
00:19:47,540 --> 00:19:50,660
You can contact these partners if you have
368
00:19:50,660 --> 00:19:51,860
pharmacy questions or need help.
369
00:19:53,180 --> 00:19:56,980
There are also partners who
can help you with other types of
370
00:19:56,980 --> 00:19:58,340
questions about your TRICARE benefits.
371
00:19:59,080 --> 00:20:02,870
You can find contact information for these partners
372
00:20:02,870 --> 00:20:05,630
at TRICARE.mil/partners.
373
00:20:08,890 --> 00:20:09,890
Next slide, please.
374
00:20:13,800 --> 00:20:17,480
Next, I want to highlight
some TRICARE publications that
375
00:20:17,480 --> 00:20:20,190
can help you learn more
about your pharmacy benefits.
376
00:20:23,300 --> 00:20:27,560
The TRICARE Pharmacy Program Handbook
is a comprehensive
377
00:20:27,560 --> 00:20:30,840
overview of pharmacy options,
covered services, and more.
378
00:20:31,830 --> 00:20:36,180
The TRICARE Pharmacy Program
Overview Fact Sheet includes
379
00:20:36,180 --> 00:20:40,660
other at-a-glance information about
prescription drug categories,
380
00:20:40,660 --> 00:20:43,010
pharmacy options,
and the TRICARE Formulary Search Tool.
381
00:20:45,530 --> 00:20:49,080
The TRICARE Costs and Fees Fact Sheet highlights
382
00:20:49,080 --> 00:20:53,020
out-of-pocket costs and fees
of various TRICARE plans
383
00:20:53,020 --> 00:20:54,450
and out-of-pocket pharmacy costs.
384
00:20:55,730 --> 00:20:59,070
To download these resources,
visit TRICARE
385
00:20:59,070 --> 00:21:01,710
.mil/publications.
386
00:21:02,910 --> 00:21:03,960
Next slide, please.
387
00:21:06,840 --> 00:21:10,520
Finally, I want to remind you
that there are
388
00:21:10,520 --> 00:21:12,390
many ways to stay up to date with TRICARE.
389
00:21:13,100 --> 00:21:16,700
Visit newsroom.TRICARE.mil to
390
00:21:16,700 --> 00:21:20,060
see the latest articles and news updates about
391
00:21:20,060 --> 00:21:20,390
your benefit.
392
00:21:22,590 --> 00:21:25,980
You can go to TRICARE.mil/
393
00:21:25,980 --> 00:21:29,790
subscriptions to subscribe to
benefit update emails and newsletters.
394
00:21:30,580 --> 00:21:33,570
And you can also
follow TRICARE on social media.
395
00:21:38,710 --> 00:21:39,790
Next slide, please.
396
00:21:42,660 --> 00:21:45,890
I'd like to thank you all
for your time and attention.
397
00:21:45,890 --> 00:21:48,990
Now let's answer some of your questions.
I'll turn things back
398
00:21:48,990 --> 00:21:52,110
over to our moderator, Christianne.
399
00:21:52,110 --> 00:21:52,270
Thank you.
400
00:21:53,380 --> 00:21:56,860
CHRISTIANNE WITTEN:
Thank you so much, Tess, for your very
401
00:21:56,860 --> 00:22:00,000
informative presentation.
I did want to confirm for those who've
402
00:22:00,000 --> 00:22:03,470
been asking, we are recording today's session
and we'll
403
00:22:03,470 --> 00:22:06,740
be posting the recording
and all of these great slides Tess
404
00:22:06,740 --> 00:22:09,980
just shared with us in the TRICARE Newsroom
405
00:22:09,980 --> 00:22:13,330
shortly, and we've dropped a link in the Q&A pod
for your reference on how to
406
00:22:13,330 --> 00:22:14,930
access our TRICARE Newsroom.
407
00:22:15,650 --> 00:22:19,220
So, as the slide
408
00:22:19,220 --> 00:22:22,820
before you indicates,
for today's Q&A session, we'll walk
409
00:22:22,820 --> 00:22:25,980
you through how you can—actually, those of you, 
many of you have already figured
410
00:22:25,980 --> 00:22:29,380
this out—
how to submit a question using
411
00:22:29,380 --> 00:22:32,600
the speech bubble icon in the Q&A pane and clicking
412
00:22:32,600 --> 00:22:36,220
on My Questions, asking your question, and
413
00:22:36,220 --> 00:22:39,490
then posting it.
We'll get through as many as we can today.
414
00:22:39,490 --> 00:22:42,640
And I'm thrilled to be joined by
our U.S. Public Health Service
415
00:22:42,640 --> 00:22:45,920
Commander Ms. Teisha Robertson
from the DHA
416
00:22:45,990 --> 00:22:49,010
Pharmacy Operations Division.
417
00:22:49,010 --> 00:22:49,310
Ma'am, are you there?
418
00:22:50,380 --> 00:22:54,150
CDR TEISHA ROBERTSON:
Yes, ma'am. Good afternoon. Good morning, I
419
00:22:54,150 --> 00:22:57,550
am CDR Teisha Robertson,
Deputy Branch Chief
420
00:22:57,550 --> 00:22:59,820
of the Purchased Care Branch
in the Pharmacy Operations Division.
421
00:23:02,730 --> 00:23:06,260
CHRISTIANNE WITTEN:
Excellent. Great to have you join us as our friendly
422
00:23:06,260 --> 00:23:09,600
subject matter expert here
from the Pharmacy Operations Division.
423
00:23:09,600 --> 00:23:12,950
CDR Robertson is also joined by a few of her
424
00:23:12,950 --> 00:23:16,970
colleagues and representatives from
not only the Pharmacy Operations Division,
425
00:23:16,970 --> 00:23:19,980
but also Express Scripts.
As I've mentioned,
426
00:23:19,980 --> 00:23:23,020
if you'd like to ask a question,
click on the speech bubble icon at
427
00:23:23,020 --> 00:23:26,470
the top of your screen to open that Q&A pane
428
00:23:26,470 --> 00:23:29,630
and then populate My Questions.
Type in your
429
00:23:29,630 --> 00:23:31,760
question at the bottom and hit submit.
430
00:23:31,860 --> 00:23:34,960
And we'll get to as many as we can,
but I'd like to kick off
431
00:23:34,960 --> 00:23:38,620
with our first question that we received,
and that is: 
432
00:23:38,620 --> 00:23:41,790
My wife has other health insurance.
433
00:23:41,790 --> 00:23:45,300
How does this affect
what pharmacy options she can use?
434
00:23:46,460 --> 00:23:49,880
CDR Robertson, I'll pass that over to
435
00:23:49,880 --> 00:23:50,210
you initially.
436
00:23:51,030 --> 00:23:54,260
CDR TEISHA ROBERTSON:
Alright, thank you, ma'am. This is a question that
437
00:23:54,260 --> 00:23:57,440
I'd like to defer to our subject
438
00:23:57,440 --> 00:23:58,530
matter experts with Express Scripts.
439
00:24:01,080 --> 00:24:04,150
AUTUM (EXPRESS SCRIPTS):
Hi, this is Autum with Express
440
00:24:04,150 --> 00:24:07,280
Scripts. Many beneficiaries
have other health
441
00:24:07,280 --> 00:24:10,380
insurance coverage through
their employer, Medicare
442
00:24:10,380 --> 00:24:13,720
Part D, or other private insurance programs. If
443
00:24:13,720 --> 00:24:17,530
you have other health insurance
with a prescription plan, you're not
444
00:24:17,530 --> 00:24:20,300
eligible to use our home delivery program unless
445
00:24:21,000 --> 00:24:24,180
your other health insurance does
446
00:24:24,180 --> 00:24:25,570
not cover pharmacy benefits,
447
00:24:26,390 --> 00:24:29,930
your medication is not covered by your other
448
00:24:29,930 --> 00:24:30,090
health insurance,
449
00:24:31,830 --> 00:24:34,700
if you've met your OHI benefit cap,
450
00:24:35,630 --> 00:24:39,440
or if Express Scripts is your pharmacy benefit
451
00:24:39,440 --> 00:24:43,040
manager. If that's the case,
your benefits will be
452
00:24:43,040 --> 00:24:46,010
automatically coordinated
when you fill a prescription at Express Scripts.
453
00:24:49,670 --> 00:24:52,680
CHRISTIANNE WITTEN: 
Great. Thanks so much, Autum. Anything additional,
454
00:24:52,680 --> 00:24:55,460
CDR Robertson,
before we move on to our next question?
455
00:24:56,690 --> 00:25:00,430
CDR TEISHA ROBERTSON:
No, ma'am. Thank you.
456
00:25:00,430 --> 00:25:03,760
CHRISTIANNE WITTEN: 
Alright. The next question from those on the line is: I
457
00:25:03,760 --> 00:25:04,290
use home delivery.
458
00:25:04,940 --> 00:25:08,020
But my prescriptions often don't come in time when I
459
00:25:08,020 --> 00:25:10,500
need them.
What can be done to fix this?
460
00:25:12,170 --> 00:25:13,030
CDR Robertson.
461
00:25:14,070 --> 00:25:17,300
CDR TEISHA ROBERTSON: 
Yes, ma'am. So, while this is usually
462
00:25:17,300 --> 00:25:20,550
with Express Scripts as well,
most prescriptions filled through TRICARE
463
00:25:20,550 --> 00:25:23,840
Home Delivery can be delivered within a week.
464
00:25:23,840 --> 00:25:27,040
Sometimes prescriptions can't be filled
because further clarification
465
00:25:27,040 --> 00:25:30,690
may be needed.
In these cases, Express Scripts will
466
00:25:30,690 --> 00:25:33,850
contact you or your doctor,
and it is also recommended that you have
467
00:25:33,850 --> 00:25:37,290
a 30-day supply of medication on hand
before your first
468
00:25:37,290 --> 00:25:41,270
order at TRICARE home delivery.
You can also track your
469
00:25:41,270 --> 00:25:44,200
prescription order status through
the Express Scripts Pharmacy mobile app
470
00:25:44,280 --> 00:25:48,090
or your Express Scripts online account. 
Or you can call 1-
471
00:25:48,090 --> 00:25:51,280
877-363-1303
472
00:25:51,280 --> 00:25:54,700
and a patient care advocate
can assist in finding their order status.
473
00:25:55,390 --> 00:25:58,460
Additionally, you can schedule refills
474
00:25:58,460 --> 00:26:01,530
for eligible prescriptions through
the Express Scripts Pharmacy mobile app
475
00:26:01,530 --> 00:26:03,060
or your Express Scripts online account.
476
00:26:04,070 --> 00:26:07,350
Express Scripts also sends order status updates
477
00:26:07,350 --> 00:26:10,390
via phone, email, and text,
so you're aware of when
478
00:26:10,390 --> 00:26:13,910
your prescription is received,
processing, delivered, or if any
479
00:26:13,910 --> 00:26:17,180
additional information is needed
to process your prescription.
480
00:26:17,180 --> 00:26:20,470
To update your communication preferences,
you can also log in to the
481
00:26:20,470 --> 00:26:23,160
Express Scripts Pharmacy mobile app
or your Express Scripts online account.
482
00:26:25,410 --> 00:26:28,980
CHRISTIANNE WITTEN:Excellent. Wow.
Thanks for walking us through all of those options. And
483
00:26:28,980 --> 00:26:32,090
it's so important
when it comes to expectation management
484
00:26:32,090 --> 00:26:35,670
to have a realistic understanding of
the turnaround time for
485
00:26:35,670 --> 00:26:39,220
prescriptions to be filled and delivered
to your home. Thanks
486
00:26:39,220 --> 00:26:42,470
so much, ma’am.
So, our next question from our audience is:
487
00:26:42,470 --> 00:26:45,930
What is OHI, referenced
488
00:26:45,930 --> 00:26:49,790
through Express Scripts?
I think the question is about the
489
00:26:49,790 --> 00:26:49,910
acronym OHI.
490
00:26:52,320 --> 00:26:55,380
CDR Robertson? 
491
00:26:55,380 --> 00:26:58,490
CDR TEISHA ROBERTSON:
OHI is other health insurance.
492
00:27:00,240 --> 00:27:02,970
CHRISTIANNE WITTEN:
Excellent. That was an easy one. Thank you.
493
00:27:04,240 --> 00:27:05,060
CDR TEISHA ROBERTSON:
You're welcome.
494
00:27:06,530 --> 00:27:09,610
CHRISTIANNE WITTEN:
So, the next question we have is: I've been using
495
00:27:09,610 --> 00:27:12,780
my local pharmacy for both my regular medications
496
00:27:12,780 --> 00:27:15,800
and specialty drugs.
Can I still get my specialty drugs
497
00:27:15,800 --> 00:27:18,230
at my pharmacy if I don't like home delivery?
498
00:27:19,900 --> 00:27:23,650
Interesting question.
I would like to defer this again
499
00:27:23,650 --> 00:27:25,580
to our Express Scripts subject matter expert.
500
00:27:27,640 --> 00:27:31,130
AUTUM (EXPRESS SCRIPTS):
Hi, this is Autum from Express Scripts
501
00:27:31,130 --> 00:27:34,710
again.
So, when it comes to filling your
502
00:27:34,710 --> 00:27:38,730
prescriptions at a retail pharmacy,
it's important
503
00:27:38,730 --> 00:27:41,990
to know if the pharmacy is in the
504
00:27:41,990 --> 00:27:45,380
network, because that will
drive the copay amount. You
505
00:27:45,380 --> 00:27:48,600
are still able to fill
506
00:27:48,600 --> 00:27:51,620
in retail pharmacies that are
outside of the network, but then
507
00:27:51,620 --> 00:27:52,690
you would have to submit
508
00:27:54,560 --> 00:27:57,790
information for
509
00:27:57,790 --> 00:28:01,150
some possible reimbursement. But
510
00:28:01,150 --> 00:28:04,300
in some cases,
you may be able to fill
511
00:28:04,300 --> 00:28:07,380
certain drugs—you may not be able 
to fill certain drugs at
512
00:28:07,380 --> 00:28:08,130
a retail pharmacy,
513
00:28:08,880 --> 00:28:12,480
because these certain medications
514
00:28:12,480 --> 00:28:16,040
are only allowed to be filled
through the TRICARE home
515
00:28:16,040 --> 00:28:19,200
delivery or a military pharmacy.
This mostly
516
00:28:19,200 --> 00:28:20,760
applies to brand name drugs,
517
00:28:21,850 --> 00:28:26,030
and we touched a bit on this
during the presentation.
518
00:28:26,030 --> 00:28:29,180
If you have a medication
519
00:28:29,180 --> 00:28:32,660
that is in that program,
you will receive
520
00:28:32,660 --> 00:28:35,790
several notifications from Express Scripts on
521
00:28:35,790 --> 00:28:39,150
the need to transfer the prescription to 
522
00:28:39,150 --> 00:28:42,180
home delivery or military pharmacy before
523
00:28:42,180 --> 00:28:45,970
your third fill, where you would
524
00:28:45,970 --> 00:28:47,650
would be responsible for the cost-share.
525
00:28:49,890 --> 00:28:53,280
More information can be
526
00:28:53,280 --> 00:28:56,480
found on this program by
527
00:28:56,480 --> 00:28:58,680
visiting Express Scripts
TRICARE Formulary Search Tool.
528
00:28:59,420 --> 00:29:02,740
And you can reach the search tool
529
00:29:02,740 --> 00:29:07,140
at www.esrx.
530
00:29:07,140 --> 00:29:07,560
com.
531
00:29:08,670 --> 00:29:09,650
/
532
00:29:10,370 --> 00:29:12,780
TFORM. Thank you.
533
00:29:14,000 --> 00:29:17,650
CHRISTIANNE WITTEN:
Great. Thanks, Autum.
You're such a great resource. We're glad
534
00:29:17,650 --> 00:29:21,570
you're here with us,
because the next question also
535
00:29:21,570 --> 00:29:24,950
is an Express Scripts-related question and
536
00:29:24,950 --> 00:29:28,290
this beneficiary asks: I use a specialty
537
00:29:28,290 --> 00:29:31,810
medication and have refills available. Do I
538
00:29:31,810 --> 00:29:35,180
refill through my Express Scripts account
as I normally would, or do
539
00:29:35,180 --> 00:29:38,270
I need to call Accredo
and set up an account with Accredo now?
540
00:29:40,220 --> 00:29:43,270
COURTNEY (EXPRESS SCRIPTS):
Good morning. This is Courtney with Express Scripts.
541
00:29:43,270 --> 00:29:45,190
So, if you had refills
542
00:29:45,940 --> 00:29:49,390
existing at Express Scripts, your
543
00:29:49,390 --> 00:29:52,540
remaining refills have been transferred over to
544
00:29:52,540 --> 00:29:55,740
Accredo. So if Accredo has not reached out to you and you
545
00:29:55,740 --> 00:29:58,750
have concerns on where your refill is, you can
546
00:29:58,750 --> 00:30:01,440
contact Accredo and they will
get that refill processed for you.
547
00:30:03,650 --> 00:30:07,610
CHRISTIANNE WITTEN:
OK, great. Thanks so much, Courtney. Glad to have a whole
548
00:30:07,610 --> 00:30:10,920
complement of folks here from Express Scripts
on the line.
549
00:30:10,920 --> 00:30:14,190
Our next question is: How do civilian
550
00:30:14,190 --> 00:30:17,300
doctors know if and what forms are needed
551
00:30:17,300 --> 00:30:20,140
to be filled out for prior authorization?
552
00:30:21,530 --> 00:30:24,690
CDR Robertson, we’ll start with you.
553
00:30:24,690 --> 00:30:27,720
CDR TEISHA ROBERTSON:
This is CDR Robertson again. So, to simplify
554
00:30:27,720 --> 00:30:31,400
the prior authorization process
for civilian providers,
555
00:30:31,400 --> 00:30:34,780
they have the option to
request prior authorization for a drug
556
00:30:34,780 --> 00:30:38,640
by either calling the
Express Scripts prior authorization line
557
00:30:38,640 --> 00:30:41,940
or by filling out and faxing the completed
558
00:30:41,940 --> 00:30:45,290
prior authorization form to Express Scripts.
The prior authorization
559
00:30:45,290 --> 00:30:48,750
forms are linked to the drug
on the Formulary Search Tool,
560
00:30:48,750 --> 00:30:52,020
which Tess earlier referenced, at www.
561
00:30:52,020 --> 00:30:53,320
TRICARE.mil/
562
00:30:53,390 --> 00:30:54,440
PharmacyFormulary.
563
00:30:56,310 --> 00:31:00,940
If anyone else has anything else to add,
please feel free. 
564
00:31:00,940 --> 00:31:01,060
565
00:31:02,690 --> 00:31:06,060
ERIC PARSONS: CDR Robertson, this is Eric.
The other thing they may have is real-
566
00:31:06,060 --> 00:31:10,190
time benefits check within their EHR
that would show them the formulary status and
567
00:31:10,190 --> 00:31:13,640
whether or not a prior authorization is required.
So, some providers
568
00:31:13,640 --> 00:31:14,370
may have that as well.
569
00:31:17,360 --> 00:31:18,890
CDR TEISHA ROBERTSON:
Thank you. Thank you, Sir.
570
00:31:20,520 --> 00:31:23,730
CHRISTIANNE WITTEN:
Thanks, everyone. OK.
And we'll keep moving right
571
00:31:23,730 --> 00:31:27,120
along here and thanks.
We have over 300 of you online and thanks so
572
00:31:27,120 --> 00:31:30,280
much for asking such great questions.
I'm sure you're not the only ones
573
00:31:30,280 --> 00:31:33,710
with these questions.
So, the next one—there are two
574
00:31:33,710 --> 00:31:36,850
related questions and one is:
Are there any differences
575
00:31:36,850 --> 00:31:40,240
in the pharmacy benefit between 
TRICARE and TRICARE
576
00:31:40,240 --> 00:31:40,700
For Life?
577
00:31:41,340 --> 00:31:44,520
And the other one related is: 
If I have TRICARE For Life,
578
00:31:44,520 --> 00:31:47,010
do I need to enroll in Medicare Part D?
579
00:31:48,450 --> 00:31:51,330
And I'd like to start with CDR Robertson on that first.
580
00:31:52,500 --> 00:31:55,950
CDR TEISHA ROBERTSON:
Alright, thank you ma'am. So, those questions
581
00:31:55,950 --> 00:31:59,050
are related and when you're aged 65
582
00:31:59,050 --> 00:32:02,500
and older and you have Medicare Part A and B,
583
00:32:02,500 --> 00:32:05,400
you automatically do receive 
coverage from TRICARE For Life.
584
00:32:06,080 --> 00:32:09,260
Medicare is your primary payer and TRICARE pays
585
00:32:09,260 --> 00:32:12,830
second to Medicare or last,
586
00:32:12,910 --> 00:32:15,970
if you have other health insurance.
TRICARE benefits,
587
00:32:15,970 --> 00:32:19,610
including covering Medicare's
coinsurance and deductible for
588
00:32:19,610 --> 00:32:22,740
services covered by Medicare and TRICARE.
When you
589
00:32:22,740 --> 00:32:25,930
reach age 65, you become eligible
for TRICARE For Life and are
590
00:32:25,930 --> 00:32:29,980
no longer able to enroll in other TRICARE plans.
591
00:32:29,980 --> 00:32:33,110
Medicare’s prescription drug plan,
Medicare Part D, is
592
00:32:33,110 --> 00:32:36,280
available to anyone who's eligible 
for Medicare Part A or
593
00:32:36,280 --> 00:32:39,540
Part B. You may want to consider Medicare Part D if
594
00:32:39,540 --> 00:32:43,100
your income is limited
because you may qualify for extra help
595
00:32:43,100 --> 00:32:44,920
with costs. You
596
00:32:45,010 --> 00:32:48,160
may benefit by enrolling in a Medicare prescription
597
00:32:48,160 --> 00:32:51,590
drug plan,
and the best resource for that is
598
00:32:51,590 --> 00:32:55,010
to contact Medicare at 1-800-MEDICARE
599
00:32:55,010 --> 00:32:56,760
for more information.
600
00:32:58,200 --> 00:32:58,790
Thank you.
601
00:33:01,640 --> 00:33:05,130
CHRISTIANNE WITTEN:
Thanks so much, CDR Robertson, grateful to
602
00:33:05,130 --> 00:33:08,670
have you here on the line helping us.
Our next question
603
00:33:09,400 --> 00:33:12,920
comes from one of our members online:
604
00:33:12,920 --> 00:33:16,100
I'm seeing a dermatologist for psoriasis
and they've
605
00:33:16,100 --> 00:33:19,760
requested my prescription through
a different specialty pharmacy and
606
00:33:19,760 --> 00:33:23,250
they're awaiting approval from TRICARE.
What can I do if
607
00:33:23,250 --> 00:33:25,930
my doctor won't use the Accredo pharmacy option?
608
00:33:27,760 --> 00:33:29,200
Let's start with CDR Robertson.
609
00:33:30,580 --> 00:33:33,980
CDR ROBERTSON:
Alright, so this is CDR Robertson again. As
610
00:33:33,980 --> 00:33:37,010
Tess referenced during the presentation,
if it is a
611
00:33:37,010 --> 00:33:40,380
medication that is currently on the maintenance
612
00:33:40,380 --> 00:33:43,700
drug list, a beneficiary is afforded the
613
00:33:43,700 --> 00:33:46,910
first two fills, at which after the third
614
00:33:46,910 --> 00:33:50,600
fill, a beneficiary must utilize 
either TRICARE home
615
00:33:50,600 --> 00:33:53,940
delivery with services by Accredo
or a military
616
00:33:53,940 --> 00:33:58,490
treatment facility
to avoid paying 100% of the cost-
617
00:33:58,490 --> 00:34:01,550
share. Beneficiaries, at that point,
at the third fill,
618
00:34:01,550 --> 00:34:03,530
they can either utilize the 100%
619
00:34:03,600 --> 00:34:07,370
cost-share or switch or move their medication,
as I mentioned, to TRICARE
620
00:34:07,370 --> 00:34:10,470
home delivery with services by Accredo or to the military
621
00:34:10,470 --> 00:34:10,720
treatment facility.
622
00:34:11,490 --> 00:34:13,090
And at that point,
623
00:34:14,250 --> 00:34:16,870
the cost-share, as I mentioned, is 100%.
624
00:34:18,130 --> 00:34:20,800
Express Scripts,
do you have anything additional to add?
625
00:34:25,680 --> 00:34:26,500
AUTUM (EXPRESS SCRIPTS):
I do not, thank you.
626
00:34:33,020 --> 00:34:36,500
CHRISTIANNE WITTEN:
Thanks, Teisha. This next question comes to
627
00:34:36,500 --> 00:34:38,230
us regarding maintenance drugs:
628
00:34:38,910 --> 00:34:42,050
For maintenance drugs, does the retailer
629
00:34:42,050 --> 00:34:45,460
know that the third refill will be full
630
00:34:45,460 --> 00:34:47,480
cost to you and advise you accordingly?
631
00:34:50,870 --> 00:34:53,950
CDR TEISHA ROBERTSON:
This is CDR Robertson again, so
632
00:34:53,950 --> 00:34:57,500
when you are filling 
maintenance medications that are part
633
00:34:57,500 --> 00:35:00,540
of what we call
634
00:35:00,540 --> 00:35:03,730
the EMM program, you do
635
00:35:03,730 --> 00:35:06,940
get notifications via letter
636
00:35:06,940 --> 00:35:10,590
informing you that after your second fill,
it is 100%
637
00:35:10,590 --> 00:35:10,700
cost-share.
638
00:35:11,480 --> 00:35:15,180
When you go to the pharmacy at your third attempt at
639
00:35:15,180 --> 00:35:19,050
that medication,
it will charge you the 100% cost-
640
00:35:19,050 --> 00:35:22,590
share. Express Scripts, if you can confirm,
I don't believe
641
00:35:22,590 --> 00:35:26,900
that retailers after the first or second fill
get prompted of this, but
642
00:35:26,900 --> 00:35:30,150
via the beneficiary notifications and at the
643
00:35:30,150 --> 00:35:33,650
third fill is where they will be informed
of the 100% cost-share when
644
00:35:33,650 --> 00:35:34,540
they go into the pharmacy.
645
00:35:36,020 --> 00:35:37,970
AUTUM (EXPRESS SCRIPTS):
Yes, I believe you covered that well. Thank you.
646
00:35:41,870 --> 00:35:45,500
CHRISTIANNE WITTEN:
Thanks so much, CDR Robertson. Appreciate your response and
647
00:35:45,500 --> 00:35:48,620
our next question is: How do
648
00:35:48,620 --> 00:35:51,660
civilian—let's see, 
I thought I asked this one. How do
649
00:35:51,660 --> 00:35:55,950
civilian doctors know if and what forms
need to be filled in prior to authorization?
650
00:35:55,950 --> 00:35:58,600
I believe we might have asked that one,
but this may be a duplicate.
651
00:36:00,300 --> 00:36:03,750
CDR TEISHA ROBERTSON:
Yeah, that's the same one that we just referenced.
652
00:36:03,750 --> 00:36:06,810
Just to kind of reiterate that
653
00:36:06,810 --> 00:36:10,550
question or response again,
providers, as Mr.
654
00:36:10,550 --> 00:36:14,190
Parsons just referenced earlier,
if they do have that real-time
655
00:36:14,190 --> 00:36:18,600
prescription benefit and they 
input the specific drug for the beneficiary,
656
00:36:18,600 --> 00:36:21,790
it does share with them if a specific medication
657
00:36:21,790 --> 00:36:25,810
requires prior authorization
or any of our other tools.
658
00:36:25,810 --> 00:36:29,470
In addition, providers as well as beneficiaries can
659
00:36:29,470 --> 00:36:31,370
check on the Formulary Search Tool.
660
00:36:32,040 --> 00:36:35,320
And it does share if that drug,
for instance, does have
661
00:36:35,320 --> 00:36:39,160
prior authorization that's linked to it as well. 
662
00:36:39,160 --> 00:36:42,540
CHRISTIANNE WITTEN:
So the follow-up then is: How does the beneficiary then
663
00:36:42,540 --> 00:36:45,370
get notified of the outcome of
the pre-authorization review?
664
00:36:46,940 --> 00:36:50,180
CDR TEISHA ROBERTSON:
And I will defer this over to Express Scripts.
665
00:36:50,180 --> 00:36:53,620
Usually, the provider as well as the beneficiary should be
666
00:36:53,620 --> 00:36:56,830
notified via formal communication,
but Express
667
00:36:56,830 --> 00:36:57,380
Scripts, if you can
668
00:36:58,440 --> 00:36:59,050
take this one.
669
00:37:02,020 --> 00:37:05,810
COURTNEY (EXPRESS SCRIPTS):
I agree.
670
00:37:05,810 --> 00:37:09,670
Notification is given when that authorization
has been approved. 
671
00:37:09,890 --> 00:37:13,270
I don't know if it's only letter or if it's by
672
00:37:13,270 --> 00:37:14,270
a preferred channel.
673
00:37:18,450 --> 00:37:21,280
CHRISTIANNE WITTEN:
Great. Thanks so much. I appreciate the clarification.
674
00:37:22,190 --> 00:37:25,990
So, the next question is a great one
pertaining to VA pharmacies.
675
00:37:25,990 --> 00:37:29,590
Do VA pharmacies count as military pharmacies
676
00:37:29,590 --> 00:37:30,860
or retail or other?
677
00:37:32,650 --> 00:37:35,720
CDR TEISHA ROBERTSON:
Great question. Express Scripts, I'm going to
678
00:37:35,720 --> 00:37:36,890
defer that one over to you.
679
00:37:43,230 --> 00:37:44,400
AUTUM (EXPRESS SCRIPTS):
Can I get the question please?
680
00:37:45,370 --> 00:37:46,220

681
00:37:50,200 --> 00:37:51,890
CHRISTIANNE WITTEN:
We're all eager to hear your answer.
682
00:37:54,390 --> 00:37:57,970
CDR TEISHA ROBERTSON:
Autum, I believe you asked for a repeat in the question? 
683
00:37:57,970 --> 00:38:02,510
CHRISTIANNE WITTEN:
Sure. The question is: Do VA pharmacies
684
00:38:02,510 --> 00:38:05,740
count as military pharmacies or retail
685
00:38:05,740 --> 00:38:05,950
or other?
686
00:38:13,280 --> 00:38:15,880
AUTUM (EXPRESS SCRIPTS):
This is Autum from Express Scripts.
687
00:38:16,670 --> 00:38:20,490
I'm going to defer back,
I think, to TRICARE a bit
688
00:38:20,490 --> 00:38:24,250
here, but I don't believe the
689
00:38:24,250 --> 00:38:27,640
VA pharmacies—[they] do not count 
as military pharmacies. If you're 
690
00:38:27,640 --> 00:38:30,950
looking at the copay structure,
691
00:38:30,950 --> 00:38:34,800
I believe they would be aligned 
with the retail copayment structure.
692
00:38:37,960 --> 00:38:41,250
CDR TEISHA ROBERTSON:
Yeah, and this is CDR Robertson to just
693
00:38:41,250 --> 00:38:44,920
add to that.
So, VA pharmacies are not
694
00:38:44,920 --> 00:38:48,130
considered military treatment facilities.
So, they
695
00:38:48,130 --> 00:38:49,960
would more apply in the bucket of "other."
696
00:38:53,540 --> 00:38:56,770
CHRISTIANNE WITTEN:
OK. Thanks so much to you both. It's helpful. I
697
00:38:56,770 --> 00:39:00,420
know we partner regularly
with the VA and appreciate this
698
00:39:00,420 --> 00:39:02,100
question and the opportunity to clarify.
699
00:39:02,860 --> 00:39:06,560
So, our next question comes from an active duty member:
I'm active duty and
700
00:39:06,560 --> 00:39:09,680
I have two children who are covered under me. 
Can I add them
701
00:39:09,680 --> 00:39:13,440
to my profile in Express Scripts
to have their medications delivered?
702
00:39:15,920 --> 00:39:19,020
CDR TEISHA ROBERTSON:
Great question and I'm sure there are others who would love to
703
00:39:19,020 --> 00:39:22,440
hear the answer to this.
Express Scripts, can I defer this to you
704
00:39:22,440 --> 00:39:25,240
in terms of walking them through
the process for doing so?
705
00:39:26,350 --> 00:39:30,060
AUTUM (EXPRESS SCRIPTS):
Yes, this is Autum again. So Express
706
00:39:30,060 --> 00:39:33,500
Scripts has an online portal.
You can
707
00:39:33,500 --> 00:39:37,160
access it through a computer or
708
00:39:37,160 --> 00:39:40,780
your phone.
We also have a mobile app
709
00:39:40,780 --> 00:39:44,710
that works a lot the same way,
so I would
710
00:39:44,710 --> 00:39:47,830
download the mobile app.
It's a great tool to
711
00:39:47,830 --> 00:39:51,250
have, especially to manage
your home delivery prescriptions.
712
00:39:51,250 --> 00:39:51,800
If you have
713
00:39:53,030 --> 00:39:57,650
beneficiaries that are underage
714
00:39:57,650 --> 00:40:00,700
that you're managing prescriptions for, you're
715
00:40:00,700 --> 00:40:04,160
able to set up an account for
716
00:40:04,160 --> 00:40:07,170
them.
You would set up a new
717
00:40:07,170 --> 00:40:10,380
account with their information.
It wouldn't just be under
718
00:40:10,380 --> 00:40:14,140
yours. And then you can
manage their prescriptions through
719
00:40:14,140 --> 00:40:15,780
that account you've developed for them.
720
00:40:19,610 --> 00:40:22,980
CHRISTIANNE WITTEN: Thanks, Autum. I appreciate that.
I'm sure there are many that fall into
721
00:40:22,980 --> 00:40:26,000
this category and appreciate the question from our
722
00:40:26,000 --> 00:40:27,260
service member online.
723
00:40:28,000 --> 00:40:31,560
So, moving right along and thanks.
Keep the questions coming.
724
00:40:31,560 --> 00:40:35,110
If I'm at a different address for half the
725
00:40:35,110 --> 00:40:38,200
year, is it easy to
have my prescription forwarded and changed?
726
00:40:39,320 --> 00:40:41,040
CDR Robertson, let's start with you.
727
00:40:46,950 --> 00:40:50,130
CDR TEISHA ROBERTSON:
Sorry about that, I was coming off mute.
728
00:40:50,130 --> 00:40:53,760
That's a great question. As
729
00:40:53,760 --> 00:40:57,070
home delivery is tied to the address on file, it
730
00:40:57,070 --> 00:41:00,290
may be beneficial that if you are going to be at
731
00:41:00,290 --> 00:41:03,370
a different location,
that you do update that address to
732
00:41:03,370 --> 00:41:06,550
ensure that if you are utilizing home delivery, that
733
00:41:06,550 --> 00:41:10,460
you get your medications to the address that's needed.
734
00:41:10,460 --> 00:41:13,050
Express Scripts, if you have
anything additional to add, please do so.
735
00:41:14,950 --> 00:41:15,940
AUTUM (EXPRESS SCRIPTS):
Hi, yes.
736
00:41:17,070 --> 00:41:20,160
Going back to the website we just talked about,
737
00:41:20,160 --> 00:41:23,940
you're really easily able to update your
738
00:41:23,940 --> 00:41:28,070
address for specific shipments within that
739
00:41:28,070 --> 00:41:31,490
online portal through the mobile app
or through the website. So,
740
00:41:31,490 --> 00:41:34,040
that's the best place to go and update that information.
741
00:41:37,900 --> 00:41:40,710
CHRISTIANNE WITTEN:
OK, great. Alright.
742
00:41:42,730 --> 00:41:46,390
Let's see. So, our next question is:
743
00:41:46,390 --> 00:41:49,890
If my local pharmacy can fill my 90-day
744
00:41:49,890 --> 00:41:53,030
routine prescription at a lower price
than home delivery, can I use
745
00:41:53,030 --> 00:41:55,550
my local pharmacy for these ongoing scripts?
746
00:41:57,460 --> 00:42:00,930
CDR TEISHA ROBERTSON:
This is CDR Robertson. In
747
00:42:00,930 --> 00:42:03,950
reference to if a retail pharmacy or your
748
00:42:03,950 --> 00:42:07,210
local pharmacy can fill a medication at a lower cost.
749
00:42:07,910 --> 00:42:12,580
The price at the 
750
00:42:12,580 --> 00:42:15,820
retail pharmacy, the copay for the
751
00:42:15,820 --> 00:42:19,740
retail pharmacy, is up to is the 30-
752
00:42:19,740 --> 00:42:23,480
day copay or up to the cost of the medication. So
753
00:42:23,480 --> 00:42:26,680
what that means is, if the medication costs are lower
754
00:42:26,680 --> 00:42:29,990
cost-share at a retail pharmacy and your
755
00:42:29,990 --> 00:42:33,370
copay is higher, you pay that lower cost-share. In
756
00:42:33,370 --> 00:42:37,700
addition, we do have a tool that is online that's
757
00:42:37,700 --> 00:42:40,850
called the Price a Medication Tool,
758
00:42:40,850 --> 00:42:42,220
where you're able to
759
00:42:42,470 --> 00:42:46,320
compare costs of your medication at a local
760
00:42:46,320 --> 00:42:49,630
network pharmacy
(even if it is a cash price, is less costly than
761
00:42:49,630 --> 00:42:53,600
your TRICARE copay), and you can
compare that price at home delivery, so that
762
00:42:53,600 --> 00:42:56,870
you can find the best value for your prescription. So, this
763
00:42:56,870 --> 00:42:59,640
tool is available online through
764
00:43:00,580 --> 00:43:04,160
express-scripts.com on
765
00:43:04,160 --> 00:43:07,290
their website as well. 
Once you have an account, you're able to
766
00:43:07,290 --> 00:43:10,420
do this comparison of 
the cost of your medication at the local
767
00:43:10,420 --> 00:43:14,110
network pharmacy to see if
it's much less costly for you to utilize
768
00:43:14,110 --> 00:43:14,440
that pharmacy. Thank you.
769
00:43:16,360 --> 00:43:20,110
CHRISTIANNE WITTEN:
Thanks so much, ma'am. I appreciate
770
00:43:20,110 --> 00:43:23,180
that. Some really great information and
great questions from folks on
771
00:43:23,180 --> 00:43:26,660
the line.
We still have over 300 of you staying
772
00:43:26,660 --> 00:43:26,760
with us.
773
00:43:28,230 --> 00:43:31,430
As a TRICARE For Life retiree, if I
774
00:43:31,430 --> 00:43:34,590
get a prescription filled at a military pharmacy, is
775
00:43:34,590 --> 00:43:35,590
there a copay?
776
00:43:36,800 --> 00:43:37,810
CDR Robertson.
777
00:43:39,240 --> 00:43:42,360
CDR TEISHA ROBERTSON:
Great question. I think we get
778
00:43:42,360 --> 00:43:46,120
asked this at least once or twice a
779
00:43:46,120 --> 00:43:49,440
year, but there is no cost-share or copayment
780
00:43:49,440 --> 00:43:50,700
at military treatment facilities
781
00:43:52,280 --> 00:43:54,550
for TRICARE-eligible beneficiaries.
782
00:44:00,120 --> 00:44:00,820
Thank you, ma'am.
783
00:44:07,740 --> 00:44:11,210
CHRISTIANNE WITTEN:
Sorry, I was trying to come off mute myself. Thank you so much. What a
784
00:44:11,210 --> 00:44:14,120
great question and glad for that clarification.
785
00:44:15,540 --> 00:44:20,450
Wish I were eligible for TRICARE For Life,
but I am not. Great
786
00:44:20,450 --> 00:44:23,770
information for those who are.
Next question is:
787
00:44:23,770 --> 00:44:26,850
What does it mean when a product is available on the
788
00:44:26,850 --> 00:44:29,980
Uniform Formulary via the MTF,
789
00:44:29,980 --> 00:44:33,930
but not covered by a retail or mail order pharmacy?
790
00:44:33,930 --> 00:44:36,030
This is from the Formulary Search Tool.
791
00:44:37,160 --> 00:44:41,480
So, someone is savvy out there using
some of the tools we're highlighting here and
792
00:44:41,480 --> 00:44:44,470
they're asking for the difference here, what this means?
793
00:44:45,860 --> 00:44:49,280
CDR TEISHA ROBERTSON:
Great question. I believe we have Dr.
794
00:44:49,280 --> 00:44:51,980
Ed VonBerg online.
Sir, are you able to take this one?
795
00:44:55,730 --> 00:44:57,140
DR. ED VONBERG:
Hello, this is Ed VonBerg.
796
00:44:57,940 --> 00:45:01,080
Can you hear me? 
CHRISTIANNE WITTEN: Yes, I can hear you, a little muffled
797
00:45:01,080 --> 00:45:01,730
but I can hear you.
798
00:45:05,110 --> 00:45:06,850
DR. ED VONBERG: 
Thank you, hopefully this is a little bit better.
799
00:45:08,470 --> 00:45:11,690
So, there are
800
00:45:11,690 --> 00:45:14,820
several different reasons that
a medication may be available
801
00:45:14,820 --> 00:45:16,520
at one point of service or another.
802
00:45:18,030 --> 00:45:21,180
There's been some mentions already of what's
803
00:45:21,180 --> 00:45:25,470
called the EMM or often called the EM program,
which is a mandatory
804
00:45:25,470 --> 00:45:28,950
program for MTF and mail usage, established
805
00:45:28,950 --> 00:45:32,120
by Congress through the 
National Defense Authorization Act of
806
00:45:32,120 --> 00:45:32,340
2015.
807
00:45:33,990 --> 00:45:35,150
That
808
00:45:36,560 --> 00:45:40,650
particular authority or mandate
809
00:45:40,650 --> 00:45:41,490
requires that
810
00:45:42,250 --> 00:45:45,990
certain maintenance medications are
811
00:45:45,990 --> 00:45:48,480
provided through mail or MTF
and there's been several discussions
812
00:45:49,570 --> 00:45:52,710
during this call regarding that. It
813
00:45:52,710 --> 00:45:55,810
also requires that
non-formulary medications, again,
814
00:45:55,810 --> 00:45:56,990
are available in the MTF.
815
00:45:59,330 --> 00:46:02,630
There are obviously also
816
00:46:02,630 --> 00:46:05,800
some programs where—
and this is controlled by manufacturers—
817
00:46:06,730 --> 00:46:10,890
where they have limited distribution networks and so those
818
00:46:10,890 --> 00:46:13,650
limited distribution networks
(again, set by the manufacturers)
819
00:46:15,150 --> 00:46:19,030
dictate to who they will
820
00:46:19,030 --> 00:46:22,380
sell drugs, which then limits
where it can be dispensed at.
821
00:46:22,380 --> 00:46:23,300
So that's just two,
822
00:46:24,200 --> 00:46:27,310
I think, common reasons why
823
00:46:27,310 --> 00:46:30,600
there may be availability
824
00:46:30,600 --> 00:46:34,030
at one point of service versus another.
There are some times
825
00:46:34,030 --> 00:46:37,240
where medications are primarily
826
00:46:37,240 --> 00:46:40,720
for acute use or they're needed urgently for
827
00:46:40,720 --> 00:46:44,570
a condition that
immediately needs a resolution. Sometimes
828
00:46:44,570 --> 00:46:47,730
you'll see those where they are available at
829
00:46:47,730 --> 00:46:51,400
a mail site, at mail point of service,
830
00:46:51,400 --> 00:46:54,570
and also at the retail point of service,
but not the mail order point of
831
00:46:54,570 --> 00:46:57,830
service, because that's generally
not appropriate for keep use.
832
00:46:58,650 --> 00:47:01,690
You'll often see those for
833
00:47:02,520 --> 00:47:05,630
infections as an example.
I hope this
834
00:47:05,630 --> 00:47:07,220
addresses your questions.
Thank you very much.
835
00:47:07,940 --> 00:47:11,080
CHRISTIANNE WITTEN:
Thanks Dr. VonBerg, I appreciate you unpacking some
836
00:47:11,080 --> 00:47:14,420
of those underlying reasons why
837
00:47:14,420 --> 00:47:17,870
that may be the case.
And thanks for the great
838
00:47:17,870 --> 00:47:21,060
question. So our next question is:
I am in an
839
00:47:21,060 --> 00:47:24,090
in-network pharmacy, what identification do I
840
00:47:24,090 --> 00:47:26,950
need to show them that I am under TRICARE For Life?
841
00:47:28,500 --> 00:47:29,480
CDR Robertson.
842
00:47:30,240 --> 00:47:33,740
CDR TEISHA ROBERTSON:
Hey, this is CDR Robertson again. Great question. So, at the in-
843
00:47:33,740 --> 00:47:36,770
network pharmacy, you may be required
to show your
844
00:47:36,770 --> 00:47:39,920
Uniformed Services ID card. If
845
00:47:39,920 --> 00:47:43,290
you are experiencing problems
at a network pharmacy,
846
00:47:43,290 --> 00:47:46,300
please contact Express Scripts.
I know we shared the
847
00:47:46,300 --> 00:47:49,700
contact information previously,
but if you have any
848
00:47:49,700 --> 00:47:52,820
issues, you can definitely follow up with them. But
849
00:47:52,820 --> 00:47:55,330
some may ask for your Uniformed Services ID card.
850
00:47:58,100 --> 00:47:58,740
Over.
851
00:48:01,150 --> 00:48:01,860
CHRISTIANNE WITTEN:
Thank you, ma'am.
852
00:48:03,320 --> 00:48:06,490
Alright, another question related to the VA, and
853
00:48:06,490 --> 00:48:09,730
that is: If I receive medication through the VA,
854
00:48:09,730 --> 00:48:12,750
am I eligible for TRICARE home delivery and
855
00:48:12,750 --> 00:48:15,960
would it be potentially beneficial
856
00:48:15,960 --> 00:48:16,260
for me?
857
00:48:18,960 --> 00:48:22,310
CDR TEISHA ROBERTSON:
This is CDR Robertson again. Another
858
00:48:22,310 --> 00:48:25,580
great question.
So TRICARE home
859
00:48:25,580 --> 00:48:30,380
delivery, as Tess mentioned
in the beginning of the presentation,
860
00:48:30,380 --> 00:48:33,700
as a TRICARE pharmacy benefit
is afforded to
861
00:48:33,700 --> 00:48:36,860
to all TRICARE eligible beneficiaries, with the exception of
862
00:48:36,860 --> 00:48:41,300
the US Family Health Plan. As mentioned for those beneficiaries,
863
00:48:41,300 --> 00:48:44,450
you can utilize the retail in-
864
00:48:44,450 --> 00:48:47,760
network pharmacy, military treatment facility, as well as TRICARE
865
00:48:47,760 --> 00:48:51,110
Home Delivery. However, if you are service-connected
866
00:48:51,110 --> 00:48:51,970
and are receiving
867
00:48:52,630 --> 00:48:56,090
care for a specific service-connected,
868
00:48:56,090 --> 00:48:59,360
it may be best that you stay with the VA for
869
00:48:59,360 --> 00:49:02,430
that specific medication, but the TRICARE
870
00:49:02,430 --> 00:49:05,500
pharmacy benefit is available to all TRICARE eligible beneficiaries.
871
00:49:06,400 --> 00:49:09,580
CHRISTIANNE WITTEN:
OK, great. Thank you, ma’am. Thank you.
872
00:49:09,580 --> 00:49:10,130
That's good news.
873
00:49:11,130 --> 00:49:14,640
So our next question is: I'm currently taking five maintenance
874
00:49:14,640 --> 00:49:18,090
meds, and one specialty med. For a few years,
875
00:49:18,090 --> 00:49:21,300
I've been serviced by Express Scripts. Can I
876
00:49:21,300 --> 00:49:24,570
get non-specialty meds filled at a
877
00:49:24,570 --> 00:49:27,090
military pharmacy to sidestep delivery charges?
878
00:49:29,280 --> 00:49:30,950
You want to start with that one, CDR Robertson?
879
00:49:31,980 --> 00:49:35,220
CDR TEISHA ROBERTSON:
Yes. Delivery charges - that's
880
00:49:35,220 --> 00:49:38,540
news to me. When you get your medications filled			
881
00:49:38,540 --> 00:49:42,490
at TRICARE home delivery or Accredo
882
00:49:42,490 --> 00:49:45,560
services, there are no delivery charges that are added on to
883
00:49:45,560 --> 00:49:49,080
your copay. In reference to the
884
00:49:49,080 --> 00:49:52,460
question with copayment, military treatment
885
00:49:52,460 --> 00:49:56,390
facility does still afford eligible beneficiaries
886
00:49:56,390 --> 00:49:59,810
no cost-share at the military treatment facility.
887
00:49:59,810 --> 00:50:03,190
If the medication is available and you're eligible,
888
00:50:03,190 --> 00:50:06,440
you can receive that medication at no cost at
889
00:50:06,440 --> 00:50:06,710
the military
890
00:50:06,790 --> 00:50:10,000
treatment facility. There are
891
00:50:10,000 --> 00:50:13,120
some instances, if a beneficiary does request
892
00:50:13,120 --> 00:50:16,160
maybe an expedited delivery or
893
00:50:16,160 --> 00:50:19,500
overnight delivery, where there is a delivery charge.
894
00:50:19,500 --> 00:50:22,860
However, if it's being shipped normally, there is no
895
00:50:22,860 --> 00:50:25,940
additional delivery charge on medications at home
896
00:50:25,940 --> 00:50:26,650
delivery or Accredo.
897
00:50:27,500 --> 00:50:30,220
CHRISTIANNE WITTEN:
Great. Thank you. Thanks for clarifying.
898
00:50:31,060 --> 00:50:35,350
Next question, also pertaining to Accredo: does TRICARE
899
00:50:35,350 --> 00:50:38,370
only approve specialty prescriptions through Accredo pharmacy now?
900
00:50:40,260 --> 00:50:43,330
CDR TEISHA ROBERTSON:
That is a very interesting question. I'm
901
00:50:43,330 --> 00:50:46,340
going to defer that over to Express Scripts
902
00:50:46,340 --> 00:50:46,900
in reference to
903
00:50:47,550 --> 00:50:48,160
that response.
904
00:50:50,730 --> 00:50:53,920
COURTNEY (EXPRESS SCRIPTS):
At this time, the DOD specialty drugs
905
00:50:53,920 --> 00:50:56,280
are the drugs that are available through
906
00:50:57,300 --> 00:50:59,620
Accredo Home Delivery.
907
00:51:01,210 --> 00:51:01,800
CHRISTIANNE WITTEN:
Thanks.
908
00:51:04,050 --> 00:51:04,740
Alright.
909
00:51:05,510 --> 00:51:09,830
Moving right along: I primarily use an MTF
910
00:51:09,830 --> 00:51:13,180
pharmacy. Can I use the tools on Express Scripts to
911
00:51:13,180 --> 00:51:14,160
manage my prescriptions?
912
00:51:17,070 --> 00:51:20,650
CDR TEISHA ROBERTSON:
So, in reference to if you
913
00:51:20,650 --> 00:51:25,040
primarily utilize 
914
00:51:25,040 --> 00:51:28,540
the MTF, the tools
915
00:51:28,540 --> 00:51:32,830
are still available at Express Scripts. However, if you're considering
916
00:51:32,830 --> 00:51:36,300
utilizing the tools to manage your prescription in terms
917
00:51:36,300 --> 00:51:39,570
of managing refills at the MTF or communication with
918
00:51:39,570 --> 00:51:42,970
your provider, those tools will not be
919
00:51:42,970 --> 00:51:45,920
accessible through the Express Scripts app.
920
00:51:46,610 --> 00:51:49,880
Unless,
921
00:51:49,880 --> 00:51:51,920
Express Scripts, you have anything additional to add to that?
922
00:51:54,330 --> 00:51:56,410
AUTUM (EXPRESS SCRIPTS):
No, you covered that well. That's correct.
923
00:51:59,580 --> 00:52:03,990
CHRISTIANNE WITTEN:
Alright. Thanks so much for the clarity there. Alright.
924
00:52:03,990 --> 00:52:07,030
Our next question is from an individual
925
00:52:07,030 --> 00:52:10,240
who says: I turn 65 in May—so happy
926
00:52:10,240 --> 00:52:14,710
early birthday—65 in May, 
and I'm approved for Medicare. How
927
00:52:14,710 --> 00:52:17,760
soon should I contact Express Scripts for refills so
928
00:52:17,760 --> 00:52:20,490
there's no break in medications?
Should I do this in April?
929
00:52:21,310 --> 00:52:22,110
CDR Robertson.
930
00:52:23,310 --> 00:52:26,730
CDR TEISHA ROBERTSON:
So, I know earlier I referenced
931
00:52:26,730 --> 00:52:31,190
the process about Medicare
932
00:52:31,190 --> 00:52:34,240
and the eligibility with
933
00:52:34,240 --> 00:52:37,420
It. In reference to managing your prescription
934
00:52:37,420 --> 00:52:40,450
if it does change over,
935
00:52:40,450 --> 00:52:43,980
I will defer that to Express Scripts
because that may be an update
936
00:52:43,980 --> 00:52:47,220
needed in the system.
So Express Scripts, are
937
00:52:47,220 --> 00:52:50,290
they able to continue that as of April,
or do they need
938
00:52:50,290 --> 00:52:51,600
to wait until they're eligible?
939
00:52:59,510 --> 00:53:00,010
Yeah.
940
00:53:02,290 --> 00:53:03,130

941
00:53:04,680 --> 00:53:07,650
COURTNEY (EXPRESS SCRIPTS):
I would repeat the question—If
942
00:53:09,120 --> 00:53:11,880
they’re newly TRICARE For Life
943
00:53:12,970 --> 00:53:16,270
in May, do they need to do anything
944
00:53:16,270 --> 00:53:19,160
specific for Express Scripts?
Is that the direct question?
945
00:53:20,840 --> 00:53:24,220
CDR TEISHA ROBERTSON:
So, I think the question was more,
946
00:53:24,220 --> 00:53:27,410
"To prevent a break in therapy,
if their birthday is
947
00:53:27,410 --> 00:53:30,850
in May, and they want to have continuation
948
00:53:30,850 --> 00:53:34,670
of their medication and 
it's at home delivery, are they
949
00:53:34,670 --> 00:53:38,040
able to maybe get it in April?"
950
00:53:38,040 --> 00:53:41,940
Just so they don't have a break,
they're asking how soon can they get their
951
00:53:41,940 --> 00:53:43,770
refills once they transition over in May?
952
00:53:47,700 --> 00:53:51,860
COURTNEY (EXPRESS SCRIPTS):
Yeah, I mean, I don't know if we want
953
00:53:51,860 --> 00:53:54,040
to reach out and try
to get more information on that.
954
00:53:55,770 --> 00:53:59,080
LENNYA BONIVENTO:
Can I jump in real quick?
This is Lennya with Benefit Education
955
00:53:59,080 --> 00:54:02,130
and Research.
I can answer the Medicare piece, which
956
00:54:02,130 --> 00:54:05,400
is, if the person's turning 65 in May, to avoid
957
00:54:05,400 --> 00:54:09,950
a break in any TRICARE coverage
(which would include your pharmacy coverage),
958
00:54:09,950 --> 00:54:13,340
you want to make sure that your Medicare Part A and B
959
00:54:13,340 --> 00:54:16,630
coverage is in effect by May 1.
So that means
960
00:54:16,630 --> 00:54:19,870
that you would enroll in Medicare Part A and
961
00:54:19,870 --> 00:54:23,970
Part B prior to, let's say,
962
00:54:23,970 --> 00:54:26,120
by March.
963
00:54:26,230 --> 00:54:30,070
Right now is when you should be
enrolling in Medicare Part A
964
00:54:30,070 --> 00:54:34,380
and B so that you have a May 1
965
00:54:34,380 --> 00:54:37,940
effective date of Medicare Part A and B.
And that would be when your TRICARE
966
00:54:37,940 --> 00:54:41,190
For Life would start and then your pharmacy coverage
967
00:54:41,190 --> 00:54:44,410
would continue without a break.
And then at that point, you 
968
00:54:44,410 --> 00:54:47,540
can continue with your pharmacy coverage
with no break and do
969
00:54:47,540 --> 00:54:49,720
your refills whenever your next refill would be.
970
00:54:53,000 --> 00:54:57,020
CHRISTIANNE WITTEN:
And that is why it is a team effort here for today's webinar to
971
00:54:57,020 --> 00:55:00,850
answer your questions. Thanks, Lennya,
and hopefully that's helpful
972
00:55:00,850 --> 00:55:04,890
to our colleague on the line,
the beneficiary who will soon
973
00:55:04,890 --> 00:55:08,370
be eligible for Medicare. Alright,
974
00:55:08,370 --> 00:55:11,520
so, we have 5 minutes remaining.
So, we are moving on
975
00:55:11,520 --> 00:55:12,640
on to our last question.
976
00:55:15,240 --> 00:55:18,450
And appreciate everyone
for your engagement with
977
00:55:18,450 --> 00:55:19,100
today's webinar.
978
00:55:21,960 --> 00:55:25,730
I'd like to ask this question here
about traveling overseas. I know
979
00:55:25,730 --> 00:55:28,960
I saw a question here about TRICARE home delivery.
980
00:55:28,960 --> 00:55:31,990
That phone number will be provided
in the slides and presentation
981
00:55:31,990 --> 00:55:35,260
that you received today.
I'd like to pose this
982
00:55:35,260 --> 00:55:38,850
question to the panel here:
I'm going to be traveling overseas. How much
983
00:55:38,850 --> 00:55:42,250
medication will I be able to get
in advance of my trip?
984
00:55:42,250 --> 00:55:43,690
Is it limited to 3 months?
985
00:55:44,760 --> 00:55:48,040
As one who travels myself, I'm very interested in
986
00:55:48,040 --> 00:55:48,110
the answer. It’s a good question.
987
00:55:49,350 --> 00:55:52,530
CDR TEISHA ROBERTSON:
Wow. Yes, definitely a
988
00:55:52,530 --> 00:55:57,800
great question. CDR Robertson here again.
So, beneficiaries
989
00:55:57,800 --> 00:56:01,050
do get a one-time waiver where
990
00:56:01,050 --> 00:56:04,160
they are able to get
991
00:56:04,160 --> 00:56:07,180
additional supply of the medication.
I will defer to
992
00:56:07,180 --> 00:56:10,400
Express Scripts to give that
a little bit more detail in terms
993
00:56:10,400 --> 00:56:11,050
of how that works.
994
00:56:16,170 --> 00:56:19,510
AUTUM (EXPRESS SCRIPTS):
Hi, this is Autum from Express Scripts. Yes,
995
00:56:19,510 --> 00:56:22,870
you can call our customer service
996
00:56:22,870 --> 00:56:26,050
line and talk to a representative there
997
00:56:26,050 --> 00:56:29,290
and just share that you're going
to be leaving the country and you'd
998
00:56:29,290 --> 00:56:33,350
like to request a vacation, a waiver. And
999
00:56:33,350 --> 00:56:36,710
using home delivery, they'll be able to get
1000
00:56:36,710 --> 00:56:40,060
that added prescription out to you, so you have
1001
00:56:40,060 --> 00:56:43,480
the medication you need while you're
1002
00:56:43,480 --> 00:56:44,060
out of the country.
1003
00:56:52,380 --> 00:56:55,590
CHRISTIANNE WITTEN:
Thanks so much, I appreciate both of your help 
1004
00:56:55,590 --> 00:56:58,970
answering that question and kudos to
1005
00:56:58,970 --> 00:57:02,040
the traveler for planning ahead.
It's very important
1006
00:57:02,040 --> 00:57:05,310
particularly to remember things like
making sure you have enough prescriptions on
1007
00:57:05,310 --> 00:57:08,530
hand before you travel, so
1008
00:57:08,530 --> 00:57:11,930
great planning.
So, we are nearing the end of today's
1009
00:57:11,930 --> 00:57:15,070
webinar. I would like to
1010
00:57:15,070 --> 00:57:18,240
thank Tess, CDR Robertson, and the entire team
1011
00:57:18,240 --> 00:57:21,560
from Express Scripts
for their knowledge and expertise they've
1012
00:57:21,560 --> 00:57:21,800
shared with us
1013
00:57:21,880 --> 00:57:25,180
today. I'd also like to extend a huge thank you to
1014
00:57:25,180 --> 00:57:28,460
all of you who stuck with us.
We have 267
1015
00:57:28,460 --> 00:57:32,180
currently online and had over 
1016
00:57:32,180 --> 00:57:35,860
300 today who participated in today's webinar.
1017
00:57:35,860 --> 00:57:39,540
We understand we couldn't get to all of your questions.
If we didn't answer your
1018
00:57:39,540 --> 00:57:42,940
question today, please refer to TRICARE.mil/
1019
00:57:42,940 --> 00:57:46,190
pharmacy and TRICARE.mil/
1020
00:57:46,190 --> 00:57:49,250
FAQs for more information.
1021
00:57:49,250 --> 00:57:52,630
And, of course,
you can also ask a question by contacting
1022
00:57:52,630 --> 00:57:52,950
Express Scripts,
1023
00:57:53,110 --> 00:57:56,860
International SOS for those beneficiaries
1024
00:57:56,860 --> 00:57:59,950
overseas, or Accredo [or] by going to
1025
00:57:59,950 --> 00:58:03,560
TRICARE.mil/questions.
1026
00:58:03,560 --> 00:58:07,090
As a reminder, again,
we will post a copy of today's
1027
00:58:07,090 --> 00:58:10,120
slide presentation and recording
on TRICARE.mil/
1028
00:58:10,120 --> 00:58:13,800
webinars shortly following today's
1029
00:58:13,800 --> 00:58:17,570
event. This concludes today's webinar
on using your TRICARE
1030
00:58:17,570 --> 00:58:21,600
pharmacy benefits.
Thank you and have a great rest of your
1031
00:58:21,600 --> 00:58:22,330
day. We're out here.