Nearly 15,000 pharmacies leaving the TRICARE network

WASHINGTON D.C. — On October 24, around 15,000 community pharmacies will no longer be part of the TRICARE military health benefits network due to a reduction in reimbursement rates by the prescription provider Express Scripts, which administers the TRICARE Pharmacy system.

In total, this removes nearly 27% of TRICARE pharmacy locations from the network.

100 lawmakers, including South Dakota Senators John Thune and Mike Rounds and South Dakota Representative Dusty Johnson, signed onto a letter requesting information about why the change was made and the impact that it could have on rural veterans.

“In the letter we have 100 members of Congress coming forward and asking some pretty straightforward questions of the VA. What’s the impact of this decision going to be, particularly in rural areas, and how are you going to monitor that?” Johnson said.

Additionally, the letter pressed for answers as to why the change is occurring on the 24th of this month rather than at the end of the year, a difference which, the letter says, “will likely lead to a disruption of care for TRICARE beneficiaries”

According to Express Scripts, about 4% of TRICARE users are estimated to be affected, as most patients tend to use larger pharmacies that will remain in-network after the change.

However, while CVS and Walgreens pharmacies remain in-network, many of the smaller chains and independent pharmacies that serve rural areas will not. According to the letter, 76.5 percent of pharmacies in rural areas are independent community pharmacies.

“There’s no Walgreens in Hot Springs or Sturgis or Custer. These communities are served, and very well by the way, by independent community pharmacies,” Johnson said. “When we create an environment where it’s harder for these pharmacies to stay in the TRICARE system, nobody wins.”

You will be able to see which pharmacies still accept TRICARE after the changes occur by going to the Express Scripts website after October 24.

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