Monday, March 30, 2015
FAIRFIELD-SUISUN, CALIFORNIA
99 CENTS

Mandatory ‘mail order’ starts for Tricare users

By
From page B10 | March 23, 2014 |

Approximately 500,000 military beneficiaries age 65 and older with chronic health conditions are being forced, starting this month, to have maintenance drug prescriptions filled by mail order rather than in local retail pharmacies.

The Tricare For Life Home Delivery pilot is a yearlong program required by law. Defense Department health officials project it will save the government $120 million per year in retail drug costs and save beneficiaries $28 million a year in lower drug co-payments.

By the time the pilot program ends, officials project that 95 percent of beneficiaries forced to use home delivery will be so satisfied with the convenience and savings they will stay with mail order voluntarily rather than return to neighborhood druggists for the kinds of medicines they will have to take for the rest of their lives.

“We are making it easier to stay,” said Rear Adm. Thomas J. McGinnis, chief of pharmaceutical operations for the Defense Health Agency. “We have auto-refills of medications where beneficiaries can check a box and, every 80 days or so, get either a phone call or an email – whatever they signed up to

receive – notifying them that their medication is going to ship next week. They only have to call a number if they don’t want that medication. So they automatically get it every 90 days. They don’t have to think about it so they don’t run out of medication.”

Another feature of TFL Home Delivery is auto-renewal of prescriptions.

“Prescriptions are only good for one year, in every state, and then beneficiaries have to go get a new prescription,” McGinnis said.

With mail order, however, the contractor, Express Scripts Inc., will query a beneficiary’s physician to ask if this time they will renew the prescription automatically or if they want to see the patient first.

“Eighty percent of the time, they will renew the prescription without having the beneficiary come in . . . so that’s going to help, again, keep our beneficiaries out of retail,” McGinnis said. “That’s why we say, ‘You only have to try this for one year and that’s it.’ You try it, you’ll like it.”

Many TFL beneficiaries have known about the pilot for months, from news reports on the mandate Congress enacted more than a year ago. So thousands of TLF beneficiaries who take medicine routinely to control high blood pressure, diabetes, cholesterol and other chronic conditions have been shifting their maintenance meds to mail order steadily during the past year.

Last month, however, every TLF beneficiary identified as having used retail pharmacies in recent years for maintenance drug refills – a total of 350,000 households – received a letter from Tricare explaining that those prescriptions must be switched to mail order by March 15.

Elderly beneficiaries who continue to use retail druggists for these types of medicines after that date will get a second letter warning them again that they must convert to mail order within 30 days.

“There will also be outbound phone calls reminding them to just call this number and we will help them transfer medication to mail,” McGinnis said.

If they continue to use local drug stores for these prescriptions, a third letter will be a final notice before TFL beneficiaries will be forced, after May, to pay 100 percent of the cost of maintenance drug dispensed at retail.

That’s the hammer for TLF beneficiaries who refuse to shift. The hook is that their co-payments will fall, saving TFL beneficiaries as a group a total of $2.3 million monthly, McGinnis said.

“It’s a no brainer, especially for the over-65 population,” McGinnis said. “Those folks average four or five medications. Even if they have just one generic and one brand name medication (home delivered), that will save them $212 a year.”

Beneficiaries on four to six maintenance medications could save more than $600 a year “for the same drugs and more convenience and you don’t have to remember to pick it up every month at the retail pharmacy,” he said.

Beneficiaries typically pay $60 a year in co-pays for generic drugs at retail. Generic drugs are free through home delivery.

Another bit of good news is that the process to shift to mail order couldn’t be easier, McGinnis said. All of the warning letters will contain the same phone number: 1-877-882-3335

“We tell them, ‘Just call this number. It’s a concierge service. They will walk you through the registration process if you have never used mail before,’ ” McGinnis said. Express Scripts staff will “get all the information from the beneficiary so it very easy to register and use mail order. They will even offer to call their doctor to transfer that prescription to the mail order pharmacy. So it’s truly a concierge-type service to help beneficiaries move.”

Not impacted by the mail-order mandate are elderly beneficiaries who have prescriptions filled in base pharmacies where the cost of drugs to the government also is far less than at retail pharmacies. TFL beneficiaries needing drugs for acute conditions or having maintenance drug prescriptions filled for the first time also can use retail outlets.

Tricare will allow waivers from mandatory mail order in special circumstances, to include TFL beneficiaries in assisted-living facilities or nursing homes where mail order might not be practical.

For several years, Tricare pharmacy officials have led an information campaign to encourage beneficiaries on maintenance drugs to use mail order because of the substantial savings. By 2011, about 1 million military prescriptions a year were being filled through mail order. By the start of 2014, that annual average was 1.77 million, an increase of 77 percent.

During the next year, because of the TFL Home Delivery pilot program, McGinnis said, mail order prescriptions should double to 3.3 million. That’s out of a total of 140 million military prescriptions filled annually across all three venues of base pharmacies, retail outlets and home delivery.

Having led the Tricare pharmacy directorate as its first chief for the past eight-and-a-half years, and more than 36 years as a Public Health Service officer and pharmacist, McGinnis will retire May 1.

Send comments to Military Update, P.O. Box 231111, Centreville, VA, 20120, email [email protected] or tweet @Military_Update.

LEAVE A COMMENT

Discussion | 1 comment

The Daily Republic does not necessarily condone the comments here, nor does it review every post. Read our full policy

  • Don Gillis (MSgt)April 01, 2014 - 10:21 am

    This program is NOT for everyone. I am one of those who was quite happy to go to my pharmacy and have "control" over my medications delivery and safety. Also, 90 days of prescriptions requires a cabinet full of meds. I am forced for now on two of my medications because they are Brand names, however, I intend to go 'generic'. and avoid this insane merry go round. I was on Home Delivery previous to the 'forced program' and got back to local retail. I am sure I am not alone in this regard. Comment???

    Reply | Report abusive comment
.

Solano News

2 drivers killed in same area, an hour apart

By Amy Maginnis-Honey | From Page: A1, 17 Comments

 
Easter activities, events abundant

By Susan Hiland | From Page: A1 | Gallery

Christians begin Holy Week with Palm Sunday celebrations

By Amy Maginnis-Honey | From Page: A1, 1 Comment | Gallery

 
My guide to dining out

By Tony Wade | From Page: A2, 5 Comments

Local governments post week’s meeting times

By Susan Hiland | From Page: A3

 
Top young spellers to compete for Solano title

By Glen Faison | From Page: A3

Police investigate shooting off North Texas Street

By Amy Maginnis-Honey | From Page: A3, 11 Comments | Gallery

 
Vallejo police seek leads in weekend homicide

By Amy Maginnis-Honey | From Page: A3

Biz Buzz: Re/Max hires new Realtor

By Susan Hiland | From Page: A10

 
Biz Buzz: PAL receives donation from glass company

By Susan Hiland | From Page: A10 | Gallery

 
Biz Buzz: Wiseman officer names Perez to key post

By Kevin W. Green | From Page: A10

.

US / World

 
Analysis finds unequal pay for women on California Capitol

By The Associated Press | From Page: A3

Songwriter injured in California crash; motorcyclist killed

By The Associated Press | From Page: A3

 
Taylor Swift wins artist of the year at iHeartRadio Awards

By The Associated Press | From Page: A4

Court ruling opens door for federal execution of murderer

By The Associated Press | From Page: A4

 
 
Police: 2 bodies found in NYC building explosion rubble

By The Associated Press | From Page: A5

 
Waving fronds around the world, Christians mark Palm Sunday

By The Associated Press | From Page: A7

Air Canada plane makes hard landing short of Halifax runway

By The Associated Press | From Page: A7

 
Small tsunami generated in Pacific after earthquake

By The Associated Press | From Page: A9

.

Living

Community Calendar: March 30, 2015

By Susan Hiland | From Page: A2

 
Today in History: March 30, 2015

By The Associated Press | From Page: A2

Horoscopes: March 30, 2015

By Holiday Mathis | From Page: B6

 
Parenting: If a father is abusive, a mother must act

By The Washington Post | From Page: B8

 
Horoscopes: March 31, 2015

By Holiday Mathis | From Page: B8

.

Entertainment

TVGrid March 30

By Daily Republic Syndicated Content | From Page: A10

 
TVGrid March 31

By Daily Republic Syndicated Content | From Page: A11

Michelle Obama declares ‘Black Girls Rock!’

By The Associated Press | From Page: A11, 3 Comments

 
.

Sports

Spartans Final Four-bound after 76-70 OT win over Louisville

By The Associated Press | From Page: B1

 
Duke back in Final Four after 66-52 win over Gonzaga

By The Associated Press | From Page: B1

 
Hamlin wins for 25th time, and fifth time at Martinsville

By The Associated Press | From Page: B2

Jimmy Walker wins hometown Texas Open

By The Associated Press | From Page: B2

 
Oakland OF Josh Reddick won’t be ready for start of season

By The Associated Press | From Page: B2

California Chrome heads to Britain, to race at Royal Ascot

By The Associated Press | From Page: B2

 
Vettel wins Malaysian GP to end Mercedes streak

By The Associated Press | From Page: B2

Joe Gibbs on son: most courageous person I’ve been around

By The Associated Press | From Page: B2

 
Chodounsky defends slalom title at US Alpine Championships

By The Associated Press | From Page: B2

South Carolina earns 1st Final Four berth, beats FSU 80-74

By The Associated Press | From Page: B2

 
Turner says Saturday regional finals highest-rated in decade

By The Associated Press | From Page: B2

Apology for wrong anthem for El Salvador before game in US

By The Associated Press | From Page: B2

 
Montoya holds off Power to give Penske 1-2 sweep at St. Pete

By The Associated Press | From Page: B2

Stanford’s Randle chases school scoring record, title at NIT

By The Associated Press | From Page: B2

 
Hamlin wins for 25th time, and fifth time at Martinsville

By The Associated Press | From Page: B2

Cain goes 4 innings in Giants win over LA

By The Associated Press | From Page: B3

 
Graveman pitches into 7th inning as A’s beat Brewers 7-0

By The Associated Press | From Page: B3

.

Business

.

Obituaries

Robert Roberts

By Nancy Green | From Page: A4

 
Janice Jewel Thompson

By Nancy Green | From Page: A4

.

Comics

Peanuts March 30

By Daily Republic Syndicated Content | From Page: B5

 
Zits March 30

By Daily Republic Syndicated Content | From Page: B5

Blondie March 30

By Daily Republic Syndicated Content | From Page: B5

 
Pickles March 30

By Daily Republic Syndicated Content | From Page: B5

Get Fuzzy March 30

By Daily Republic Syndicated Content | From Page: B5

 
Sally Forth March 30

By Daily Republic Syndicated Content | From Page: B5

For Better or Worse March 30

By Daily Republic Syndicated Content | From Page: B5

 
Baldo March 30

By Daily Republic Syndicated Content | From Page: B5

Garfield March 30

By Daily Republic Syndicated Content | From Page: B5

 
Dilbert March 30

By Daily Republic Syndicated Content | From Page: B5

Baby Blues March 30

By Daily Republic Syndicated Content | From Page: B5

 
Frank and Ernest March 30

By Daily Republic Syndicated Content | From Page: B5

B.C. March 30

By Daily Republic Syndicated Content | From Page: B5

 
Wizard of Id March 30

By Daily Republic Syndicated Content | From Page: B5

Beetle Bailey March 30

By Daily Republic Syndicated Content | From Page: B5

 
Rose is Rose March 30

By Daily Republic Syndicated Content | From Page: B5

Sudoku March 30

By Daily Republic Syndicated Content | From Page: B6

 
Bridge March 30

By Daily Republic Syndicated Content | From Page: B6

Word Sleuth March 30

By Daily Republic Syndicated Content | From Page: B6

 
Crossword March 30

By Daily Republic Syndicated Content | From Page: B6

Cryptoquote March 30

By Daily Republic Syndicated Content | From Page: B6

 
B.C. March 31

By Daily Republic Syndicated Content | From Page: B7

Blondie March 31

By Daily Republic Syndicated Content | From Page: B7

 
Peanuts March 31

By Daily Republic Syndicated Content | From Page: B7

Baldo March 31

By Daily Republic Syndicated Content | From Page: B7

 
Rose is Rose March 31

By Daily Republic Syndicated Content | From Page: B7

Beetle Bailey March 31

By Daily Republic Syndicated Content | From Page: B7

 
For Better or Worse March 31

By Daily Republic Syndicated Content | From Page: B7

Dilbert March 31

By Daily Republic Syndicated Content | From Page: B7

 
Garfield March 31

By Daily Republic Syndicated Content | From Page: B7

Pickles March 31

By Daily Republic Syndicated Content | From Page: B7

 
Zits March 31

By Daily Republic Syndicated Content | From Page: B7

Sally Forth March 31

By Daily Republic Syndicated Content | From Page: B7

 
Get Fuzzy March 31

By Daily Republic Syndicated Content | From Page: B7

Wizard of Id March 31

By Daily Republic Syndicated Content | From Page: B7

 
Baby Blues March 31

By Daily Republic Syndicated Content | From Page: B7

Frank and Ernest March 31

By Daily Republic Syndicated Content | From Page: B7

 
Word Sleuth March 31

By Daily Republic Syndicated Content | From Page: B8

Bridge March 31

By Daily Republic Syndicated Content | From Page: B8

 
Sudoku March 31

By Daily Republic Syndicated Content | From Page: B8

Cryptoquote March 31

By Daily Republic Syndicated Content | From Page: B8

 
Crossword March 31

By Daily Republic Syndicated Content | From Page: B8