Delayed TRICARE pharmacy increases are mandated by Congress as part of the FY2018 National Defense Authorization Act (NDAA) and will begin Jan. 1, 2020. On that date, a 90-day supply of generic drugs received through the program’s Express Scripts mail-order pharmacy will increase from $7 to $10. Co-pays on brand-name drugs received through the mail will go from $24 to $29. The price for non-formulary drugs rises from $53 to $60. Generic drug prescriptions filled at retail pharmacies will see the cost rise from $11 to $13 for a 30-day supply, while the same supply of brand-name medications will increase from $28 to $33. Non-formulary drugs – those not on TRICARE’s list of fully covered medications – will go up from $53 to $60. Prescriptions filled on base will continue to be free. TRICARE Open Season and the Federal Employee Dental and Vision Insurance Program (FEDVIP) enrollment begins Monday, November 11th and ends on Monday, December 9th. During TRICARE Open Season, beneficiaries can: Do nothing and stay in their current TRICARE health care plan through 2020 or as long as they are eligible; Enroll in a plan if a beneficiary is eligible for a TRICARE Prime option or TRICARE Select but not enrolled; or change plans if a beneficiary is already enrolled in a TRICARE Prime option or TRICARE Select, beneficiaries can switch plans and switch between individual or family enrollment. If an eligible person is not already in a plan and doesn’t enroll in a plan, they are only eligible for care at a military hospital or clinic if space is available. Outside of TRICARE Open Season, beneficiaries can enroll in or change enrollment to TRICARE Prime or TRICARE Select following a Qualifying Life Event (QLE). A QLE is a certain change in life, such as marriage, birth of a child or retirement from active duty, which may mean different TRICARE options are available. A TRICARE QLE opens a 90-day period for beneficiaries to make eligible enrollment changes. A QLE for one family member means all family members may make enrollment changes. Outside of the Federal Benefits Open Season, beneficiaries may only make changes to their existing FEDVIP plan if they experience a QLE. Remember, FEDVIP QLEs may be different from the TRICARE QLEs. Dental premiums will increase 5.6 percent and vision premiums will increase 1.5 percent on average. If you wish to change your FEDVIP plan, you must either do so during open season or following a FEDVIP QLE. For 2020, FEDVIP offers 10 dental and four vision carriers to choose from. To help select the right dental and/or vision coverage, beneficiaries can go online and compare the many 2020 plans. The rates (premiums and cost-shares) are based upon where you live. The website allows you to compare up to three plans at one time, side-by-side. For more information, contact Sandra at the Veterans Service Office at 602 Strong Ave on Tuesdays and Thursdays from 10am to 3pm, or call 365-3612.
Sandra G. Van Zant,
Veterans County Service Officer
