Retirees will pay more for Tricare pharmacy copays, enrollment in 2022


Military families and retirees who use retail pharmacies or the Tricare mail-order system for their medications will see an increase in co-payments in 2022, according to a notice to be published in the Federal Register on Tuesday.

Likewise, military retirees still considered to be of working age – those under 65 who are not old enough for Medicare and Tricare for Life – can expect to pay more in health care enrollment fees. , although the exact amount of the increase has not yet been calculated. to be determined.

Prescriptions for all Tricare recipients at retail pharmacies will cost $ 14 for a 30-day supply for a generic drug, compared to $ 11; $ 38 for a brand name drug, compared to $ 33; and $ 68 for a drug not on the list not on the Tricare list of covered drugs, compared to $ 60.

Eligible patients can save money by using military pharmacies, which charge no co-payments, or they can reduce the costs of regularly prescribed drugs by using Tricare’s mail-order pharmacy, operated by Express Scripts.

User fees for the mail order pharmacy will also see an increase. The cost of a generic prescription will drop from $ 10 to $ 12 for a 90 day supply, and from $ 29 to $ 34 for a brand name drug for a 90 day script. Drugs not listed will cost $ 68.

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The annual registration fee for Tricare Prime and Select is also expected to increase for retired career military personnel and their families, but the amount of the increase has not yet been determined as it is based on adjusting the cost of the life calculated for the pay of retired military personnel. , which is typically released in mid-October.

The tuition fee hike is expected to be significant this year, as military retirees could experience the biggest increase in their retirement pay in nearly 40 years. In June, the projected increase in the cost of living, or COLA, was 5.1%, which means that retirement pay and Tricare Prime enrollment fees could also increase by that percentage, to a few tenths. close.

Currently, military personnel who retired prior to January 1, 2018, known as Group A retirees, pay $ 303 per year for an individual and $ 606 per year for a family.

Individuals designated as Group B retirees entered service on or after January 1, 2018 and left military service, primarily medical retirees and their family members. This group currently pays an annual registration fee for Tricare Prime of $ 366 per person and $ 732 per family.

Group A retirees who use Tricare Select started paying an annual registration fee this year, $ 150 for an individual and $ 300 for a family, while the Group B retiree registration fee for Select is $ 471 for an individual or $ 942 for a family.

Both groups are subject to the COLA adjustment and will see their fees increase.

Surviving family members of godparents who died on active duty or service members who retired medically prior to January 1, 2018, and their families who are enrolled in Tricare Prime are exempt from increases as long as they remain in this program. health.

Tricare for Life beneficiaries pay nothing for this program, which serves as a secondary payer for Medicare. But they are also likely to see an increase in their health care costs, as they are required to have Medicare Part B, which has monthly premiums based on income. Medicare Part B premiums are expected to increase based on COLA.

In addition to increases in co-payment for pharmacies and increases in registration fees, some specialized populations within the Tricare system will also pay more, including reservists, young adults and military personnel in transition.

This year, the Open Season is scheduled to start on November 8 and end on December 13. During this period, eligible beneficiaries can sign up for Tricare Prime or Select if they have other insurance or change plans. If they are happy with their current Tricare health plan, there is nothing they can do and stay enrolled.

If they do not make a change during the Open Season, beneficiaries must wait for a “qualifying life event”, such as loss of health insurance provided by another insurer, retirement, marriage or divorce, have a baby or adopt, move or grow old. from Tricare.

Over 4.7 million beneficiaries are registered with Tricare Prime and nearly 1.7 million patients use Tricare Select. 2.1 million additional beneficiaries use Tricare for Life.

Do you have more questions about Tricare? Phone numbers and more information can be found on the Tricare website.

– Patricia Kime can be contacted at [email protected] Follow her on Twitter @patriciakime.

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