New Prescription Drug Copayments Effective October 1, 2011

US Family Health Care - A TRICARE Prime health plan with special benefits

New Prescription Drug Copayments Effective October 1, 2011

In August 2011, a change was made to the prescription drug copayments for all military health plans. This change was approved by the Assistant Secretary of Defense for Health Affairs. US Family Health plan members' prescription drug copayments will change effective October 1, 2011.

The new copayments are listed in the chart below:

PHARMACY

COPAY TIER

COST OF PRESCRIPTION
PER FILL*

COST OF PRESCRIPTION
PER YEAR

Generic Drugs

Mail Order

Free

Free

Local Pharmacy

$5

$60

Brand Name Drugs

Mail Order

$9

$36

Local Pharmacy

$12

$144

 Non-Formulary Drugs

Mail Order

$25

$100

Local Pharmacy

$25

$300

*Retail is for up to a 30-day supply per fill. Mail Order is for up to a 90-day supply per fill.


Prescriptions filled by mail order will have lower co-pays than those picked up at a local pharmacy. If you are not using mail order now, talk to your local PacMed pharmacy. They can help you move your prescriptions to mail order so you can save money.

Generic drugs will cost much less than brand name drugs—in fact, generics will be free by mail order. If you are not currently taking generic drugs, ask your doctor if a generic would work for you.

Here is an example of how much you could save by using generics at mail order:

  • If each month you used a local pharmacy to fill 3 generic, 2 brand, and 1 non-formulary medications, you would pay $768 in copayments each year.
  • If you received these same prescriptions by mail order, you would pay $172 in copayments each year. That’s a savings of nearly $600 per year.
  • If your doctor changed all these medications to generic drugs, you would get them for free if you used mail order.

You may be able to save money on your medications. If you are refilling them at a local pharmacy (including PacMed pharmacies), ask about moving them to mail order. At your next doctor’s visit, ask if a generic drug could replace a brand drug you are currently taking.


About the US Family Health Plan

US Family Health Plan is a TRICARE Prime option available to families of active duty military, retirees and their eligible family members, including those age 65 and over, through networks of community-based hospitals and physicians in six areas of the country.

US Family Health Plan enrollment is offered through:

  • JOHNS HOPKINS COMMUNITY PHYSICIANS | 1-888-400-4200
    Serving central Maryland and parts of Pennsylvania, Virginia and West Virginia
  • MARTIN’S POINT HEALTH CARE | 1-888-241-4556
    Serving Maine and New Hampshire
  • BRIGHTON MARINE HEALTH CENTER | 1-800-818-8589
    Serving central and eastern MassachUSetts, including Cape Cod, and Rhode Island
  • SAINT VINCENT CATHOLIC MEDICAL CENTERS | 1-800-241-4848
    Serving parts of New York, all of New Jersey, eastern Pennsylvania and southern
  • Connecticut CHRISTUS HEALTH | 1-800-678-7347
    Serving southeast Texas and southwest Louisiana
  • PACIFIC MEDICAL CENTERS | 1-888-958-7347
    Serving the Puget Sound area of Washington State

For more information, visit the US Family Health Plan Web site.


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