Mail-Order Those Drugs: A Tricare How-To

Getting Tricare prescriptions by mail doesn't have to be impossible. We've got the step-by-step. http://wp.me/p1d7d0-8J8

Like many military things, receiving medication via mail through Tricare pharmacy home delivery confounds me. Once upon a time I somehow managed to get a birth control prescription delivered by mail-order instead of paying for it at Walmart. I’m not even sure how I set it up, honestly. And that’s why when the prescription ran out I couldn’t figure out how to make it happen again.

The Express Scripts website had locked me out for reasons I didn’t really know. My civilian provider seemed completely incapable of getting my renewal called into the Express Scripts system. I gave up, switched the military treatment facility (MTF) and started getting it in-person every three month from the on-base pharmacy.

Yes, the mail-order pharmacy won that battle. But it did not win the war. Because now I’m back, figuring out how the heck to use it so that you can, too.

Getting Tricare prescriptions by mail doesn't have to be impossible. We've got the step-by-step. http://wp.me/p1d7d0-8J8

Why Tricare pharmacy home delivery matters:

Plenty of Tricare users will be switching to mail-order for their regular, daily drugs over the next few months thanks to a Tricare rule change. That switch requires non-active duty and non-overseas users to buy name-brand maintenance medication through the mail-order system or pick them up (for free) at the MTF.

If you don’t live near an MTF, mail-order is going to be your only option. The time to figure out how to use it is now.

The bonus here is that mail-order is actually cheaper than what you are paying right now at a retail pharmacy — and an MTF is free. Right now you are paying $60 at a retail pharmacy for 90-day name-brand drug supply. By mail you’ll only pay $16 for a 90-day supply. It’s pumpkin spice latte time, people. Add that extra cash to your Starbucks fund.

What is a maintenance drug?

Maintenance drugs are medications that you take every day to manage a chronic condition. Drugs like Prozac, name-brand cholesterol, blood pressure or allergy medications fall into this category.

Not currently considered a “maintenance” drug? Birth control. That’s was weird to me because as far as I’m concerned, birth control is the very definition of a maintenance drug (maintaining my sanity! I kid. Sort of.). But that doesn’t mean it won’t be added later, Tricare officials said. The current list was put together for pilot program done with the Tricare for Life users, all of whom are over 65-years-old. You know who doesn’t use birth control? People who are over 65. And so it isn’t on the list.

Tricare officials note that the list of what is considered a maintenance medicine will grow and change — so stay tuned.

How to switch your current prescription to mail order:

If you have a civilian, non-military treatment facility provider (which you probably do if you’re worrying about this), you have a few options:

You can call Express Scripts and talk to the very nice people (no really, I’ve tested this — they are very nice and helped me unlock my account) and they will request it be moved from your doctor for you. You just need to give them the drug name and information and the name of your provider. Boom. They take care of it. If they can’t get your doctor’s office to respond within 10 days, you’ll get  an email or letter in the mail (your choice) that it didn’t work. If that happens you can try one of these other methods. If you’re lucky your doctor’s office will confirm it within just a few hours. Their number is: 1-877-882-3335.

— You can ask your provider to send in your prescription electronically to “Express Scripts Mail Pharmacy.” Doing so should not be impossible for them … but it didn’t go so well with my provider, so you’re on your own with this one.  They can also fax it. The form for that is on the same page as the one I talk about below, so read on.

— You can print out and mail in a form. Yes, I said “mail.” To do this you need to be able to find the form on the Express Scripts website.

Easier said than done? That’s why I’m here. Go to the Express Scripts Tricare website. Once you are registered (yeah, I know — it’s a pain) visit the “Health and Benefits Information” tab, and choose “print forms” from the menu. A box will pop-up with the form you need to fill out and mail. To do this you will also need a physical copy of your prescription. And that one I can’t help you with.

If you are seen at an MTF and really want to do the mail order thing (even though you’ll have to pay for it … but maybe $16 every 90 days is worth not having to ever go into your MTF pharmacy again), you can ask your provider to fax in an order or you can call Express Scripts and ask them to make a request.

How to get a new prescription into the mail-order system.

If you’ve just been prescribed a new maintenance drug, you probably want to start taking it today — not in a few weeks when they can get it shipped to your house.

So how should you proceed?

First, fill your prescription for your first month at your retail pharmacy. Tricare will cover your initial purchase under the old $20-per-30-days rate.

Then, call Express Scripts  (1-877-882-3335) and ask them to help you move your prescription over to the mail-order system. You’ll want to do this sooner rather than later, as it can take a few weeks for delivery of the drug to start.

How to get a prescription from your civilian provider to your local MTF:

You have two options:

— You can hand carry it. But make sure the place you are hand carrying it to will fill prescriptions from providers outside of their specific practice. For example, our local MTF has a community-based satellite office called a “Medical Home” with its own pharmacy. It happens to be located across the street from my kids’ civilian provider. Genius that I am, I decided that instead of paying out of pocket at Publix for expensive antibiotic for Chronic Ear Infection Kid, I would just trot that piece of paper across the street and get the drug at the MTF pharmacy. But no dice — they only fill drugs there are ordered by in-house doctors.

— You can have it sent electronically. All MTFs accept electronic prescriptions from civilian providers, Tricare officials told me. Easy.

Bonus tip: make sure you research ahead of time whether or not your MTF carries the drug in question. Not all drugs are carried by MTF pharmacies.

 

About the Author

Amy Bushatz
Amy is the editor in chief of Military.com’s spouse and family blog SpouseBuzz.com. A journalist by trade, Amy also covers spouse and family news for Military.com where she is the managing editor of spouse and family content. An Army wife and mother of two, Amy has been featured as a subject matter expert on CNN.com, NPR, Fox News, NBC, CBS, ABC and BBC as well as in the New York Times, Wall Street Journal and Washington Post. Follow her on twitter @amybushatz.
  • Nelson

    My concern is with the U.S. Postal Service,
    Somehow we always have to go to the
    Post Office to pick up the medication. Very
    Good service at the Post Office. The best.
    I just want to know why they don’t knock on the door of my house or at least leave a note.
    Ma’am this crucial medication is needed.
    We consider the word “Drugs” is more street
    Language. Thank you for your service.

    • oldernavyretiree

      Nelson, it has to be your Post Office. They must have some type of rule or something. I have been using this service for a couple of years now, have never had a problem. They contact me when my prescription is out (I have them contact my doctor for a refill – it’s that easy!), they refill y prescriptions without me having to remember to call or go to the MTF for it. My Post Office leaves it in my mailbox. If the package is too big for the mailbox, they leave it at my doorstep. It’s great. It’s easy. And most of the time is free. The word “drug” really isn’t using with the Tricare Mail Pharmacy, it’s Pharmacy.

      • Vern

        I glad you never had a problem. I did. The MD sent the prescription to ExpressScripts and they said already had the 28 day fill. According to their instructions get your first fill then have MD send to them. They would fill. I called just before injection pen would expire and was told they did not have me in system. Later they called wanted to know if I need a refil, answer not at this time. Called to get prescription filled again no record. Old saying, fool me once, shame on you, fool me twice shame on me. They don’t get a third chance. Walgreens had every month for two years which was max. Outside cost $750.00. My cost $5.00.

  • Guest

    Thanks for the article. Useful info. However at my location (stateside) the MTF will NOT accept scripts electronically from civilian providers. It’s done by paper only.

    • Amy_Bushatz

      OK see. I wondered that. But the Tricare guy said “they all do” so I’m just like . ….

    • Jes

      Same at ours. We were told they no longer accept electronic but do accept hand written. The civilian Dr. Told us that. I didnt ask at the pharmacy. Thwey uawd to do it up until about a month ago then said nope we can not do it anymore.

    • oldernavyretiree

      But the Tricare Mail Pharmacy can still fill it for you, mail it in like it states on their website. Once they have the prescription on file they will continue to fill it for you. Easy!

    • Amy_Bushatz

      Guest — Tricare INSISTS that all MTFs accept electronic scripts, but notes that not all pharmacies within the MTF may. For example, here at Fort Campbell we have a pharmacy in the hospital and the “town center” pharmacy. It’s possible that the town center doesnt accept them but the hospital might. Could that be true in your case? Or is Tricare simply wrong? (Very possible)

    • oldernavyretiree

      Guest, that’s not exactly true, maybe YOUR MTF doesn’t, but the one I use does. In fact I went to my doctor this morning, needed 2 prescriptions, she (my doctor) electronically submitted them to the MTF that I use with no problem. Granted it didn’t always used to be this way, but it is now. All I had to do was stand in the pick up line at the MTF pharmacy!

      You might want to check with your region, NOT Express Scripts, but the Tri-Care region you are assigned to and the MTF you use, they can help you. The toll free number is on the back of your Tricare card.

  • Nelson

    Thank you very much. I am U.S Army
    veteran. Also my wife served 22 years
    and retired as a Colonel in the U.S.
    Air Force. My dad served 23 years in the
    Infantry. My brother did Desert Storm as
    Major in the Air Force (sometimes he is sick)
    and my oldest brother died in Vietnam as a
    Spec4 U.S. Army Rangers.
    We are military 100% and I still consider
    myself a soldier for life because I am Service
    Connected DAV.
    I enjoy your articles. Keep up the good work.
    Those that served and their spouses need
    their medication ASAP. They earned it.

  • Milinda

    I have been using Express Scripts for about 10 years now, including the last 3 years overseas. When I have had an issue, they are very responsive and helpful when you call them. I have had very few hiccups with mail order which is a relief because the MTF pharmacy frequently cannot get some of my maintainence meds overseas. It’s comforting to know that I will get my meds in plenty of time with out running out.
    2 things I would encourage to keep mail order working for you.
    1. Check your account on the Express Scripts website. Ensure the address and payment information is always correct. Check the delivery dates of your scripts so you are tracking where they are in the system. Do your due diligence just like you would an online bill that you pay.
    2. If you are moving, ensure you change your address in a timely manner on the website so your deliveries won’t lapse or be redirected.
    3. In Express Scripts, your prescriptions are good for 12 months and then they require a new one from your doctor. I’ve tried to get all of mine on the same cycle but moving has interrupted that so they are not all on the same rotation.
    Just like any other online system, maintain it and track it and Express Scripts will work very well for you and filling your meds will be relatively stress free.

  • Nelson

    Dear Older Navy Retiree,
    Thank you very much indeed for your advice.
    I appreciated it very much!
    However my wife wrote a complaint. The United States Postal Service took action immediately.
    They caught an employe trying to steal the medication. He had 30 years of service. So they gave him a slap on wrist and retired.
    He was switching them around the office.
    Never left a slip or rang my doorbell. We did not press charges on him. That is not me.
    I would never give somebody a black eye and ruin his reputation.
    I do window pick up. They are the best

    • MichaelB

      As a 20 year AF retiree and retired USPS electronics tech, that postal employee ruined his own reputation and caused a black eye on the USPS the first time he stole from the mail. I appreciate your concern for his reputation, but you should have pressed charges.

      • Nelson

        Thank you very much for your service and your concern. Also your advice is very much appreciated. I have a family. Wife, daughters and grandchildren. What if he goes postal? Or a friend of his, perhaps a family member drives by and things go bad for my home?
        It’s like open season out here in the USA on anyone. Those were serious charges that not only him but his family innocent people would have been humiliated and embarrassed. And the Post Master told me that this person was also a veteran. Go figure.
        Thank you Mike.

  • Lazarus439

    There are two things about the program I DO NOT like. I am in TFL and this a test article from the program – not a willing one – for the reasons noted below.

    All my prescriptions are no longer all together in one pharmacy. When I have to have a acute prescription filled locally, I am not protected by any drug interaction information that might otherwise surface. When I had one filled the other day, the pharmacist winced when I told her all my scripts were not filled at her pharmacy.

    Express Scripts cannot handle a delivery address that’s different from my billing address. I have my drugs shipped to my office because I don’t want them baked in the community mailbox (very common in the west) where temps can exceed 150 (yes, one hundred fifty) degrees. The problem is the EOBs also show up at my office.

    It’s not a show stopper but it speaks to a lack of flexibility and understanding that not everyone spends their lives sitting at home waiting for their pills to arrive. With the forces expansion to users about whom even Express Scripts must acknowledge have lives other than getting their drugs.

  • Sadie

    I have had two different “mantinance” prescriptions run out with express scripts. And I don’t mean I forgot about them or didn’t renew in time, I was informed both on my account and over the phone that they just plum ran out of them. That was a month out, two weeks out it had not been remedied, I promptly stopped using them. One prescription I have they don’t even carry, not it not the generic, nadda. That particular one I can’t play around with I have to have either it or the direct generic, no substitutions. i have had nothing but issues with express scripts.

    • Amy_Bushatz

      Sadie — I heard something similar from another reader via email and I’m looking into it. Thanks for the note!

      • Gary

        My wife has had constant trouble getting her blood pressure medicine via Express Scripts; they simply will not accept a prescription for Accupril,saying it is not on the approved list. I thought we could have this filled and pay the difference. Is that not the case? Gary

        • jim

          I guess I do not quite understand your issue getting Accupril from Express Script, both Brand name and Generic are on their formulary list to fill your prescription request

  • Tim

    They will not fill monthly meds that are “controlled drugs”. another blog said they do fill CD’s. Just tried to get it through mail-order and it is a No Go. Under the new rules my normal $8 per month charge will jump to $20 because this is a maintenance drug.

  • Vince

    EScripts is a rip-off, and one that denies more than assists vets with medical needs. Thank the Obama admin for this sorry service to those of us who have served/suffered in uniform. vmv

    • V Dixon

      You are blaming the wrong person. It is the Clinton administration that gave Express Scripts such power. They took a lot of jobs away from people here in the states and gave them to the Phillipines so George Paz, CEO could get bigger bonuses. I hate dealing with them. I actually called the Dept. of Defense about my medication not coming due to they said I had other health insurance. I called Medicare, Tricare no one could tell me who the other insurance was. So I called DOD and within 30 minutes I had a phone call telling me that they were shipping my medication overnight at no cost to me. You just have to fight them all the time.

  • Pat

    Yes, express script does run out. They well list the drug as “” Back-Order” which means they are all out. For me it was atenolol, which is used for high blood pressure.
    Took them 2 1/2 weeks to get it in. Wal-Mart has atenolol, 100 pills for $10. That is, if I pay for it.
    After express script filled the prescription , they changed the received date of the prescription to the day before they filled it. So their records show they only took one day. Not true!!!
    Check complaints on the web for express script,

  • Ken

    I’m through with Express Scripts!! I’ve been with them for about six years, five of which have been on-going battles to get my “maintenance” drugs to me on time, and in one shipment. As I only see the doctor once a year, the scripts (3) go in at the same time. But, Express Scripts split the orders and send them at their convenience. Just recently, they stopped sending my Lisinopril (blood pressure med) all together. I called to see why as they had a current prescription for it. It was then they told me that the couldn’t get it from the manufacturer. Wonder when they were going to tell me they couldn’t get it so I could make other arrangements?? Now, I drive 73 miles to a MTF and get my three meds at one time. At least they have them in stock. Incidents like this have gone on for years with me. It does no good to call ES. I’ve lost track of the times I’ve been told by the agent that, “as we speak I’m fixing it”. However, it doesn’t get fixed. Also, I have talked to people identifying themselves as supervisors, with no success, and have asked for someone in management. Ended up speaking with a “Frank”, supposedly in management. He told me that he personally wants to follow me and the problem I’ve been having. So, when my next scripts arrived without all three being filled, I called him at the “personal phone number and extension” he gave me. It turns out there is no Frank in management!! So, it’s worth driving to a MTF and not having the aggravation of dealing with ES.

    • Guest

      Why not drive to a MTF??? Well, I live in Michigan and there are no bases any more. They have all been closed. Tried Express Scripts years ago and TWICE they “lost” me at the turn of a new year. No prescriptions arrived and when called they told my husband that I did not exist. He set up a new account for me and the same thing happened the next new year. That’s when we switched to Walmart pharmacy. They have never lost me and there is always a Walmart close by.

  • Charles

    Are you aware that a person CANNOT cancel their ES account. You are committed because “It is part of Tricare”. I was told this per telecom with Tricare.

    • Ken

      Yes, I’m aware of that. But, as long as I can go to an MTF, I don’t have to get my meds from Express Scripts. I have instructed my doctor, and her nurse, NOT to send anything to ES. Even if ES calls them for a prescription renewal, they are not giving them a renewal. I get my hard copy and take it to the MTF. As I mentioned, it is worth the drive to the base just so I don’t have to mess with ES any more.

  • mike gibson

    ever since generic had no copay I have only received my only drug with copay they been back order forever

  • Gabe G.

    Why fix things when it isn’t broken? The MTF Pharmacy were doing a great job mailing medications before why the change? Because now we are burden with paying a co-pay. Ok, that’s fine but why we have to resort to having Express Scripts doing it when we could just left it with MTF Pharmacy and be done with it?. Express Scripts customer service is in general, good until I asked one of their rep to transfer my current medications to MTF for pickup. Then she get a little irritated and told me they can’t do it and for me to call MTF so MTF will call them to request the transfer. When I asked why I could easily transfer my current MTF medications from MTF Pharmacy to Express Scripts for mailing but couldn’t do the reverse, she got testy and told me that I was not listening to her. So I hanged up and call MTF Pharmacy who told me that they don’t call Express Scripts but for me to call my provider to issue me a new prescription. I hope MTF Pharmacy and Express Scripts could talk to each other and iron out their differences of information so it would not be a burden to us to be making calls back and forth between them. Good luck to you!

    • cat

      my husband did his 23 years, so, yes, he is a retiree.. 20 years ago.. we are both still under 65, working and have outside doctors (but no pharmacy coverage) and used the hospital mail order system without a single problem. I am on 14 medications (5 are no longer covered by the military, all 14 used to be.. I pay $20 per 90 for 4 and $40 for 90 for the other, thanks to belonging to Costco), he is on 4 (1 of his isn’t covered by the military, we are lucky that it’s only $10 for 90 days). I may “only” be 62, but I cannot stand in lines, even with my canes, without moving my legs and stretching my back, all of which apparently shows me as “impatient” and “rude.” (Not all disabilities are visible, folks!) So, now, it’s generally 45 minutes to turn in a new prescription, another 45 at the pick up line. I do my refills online, so I can do a screen shot and print that out (about 20% of the time, they “forget” to fill), then have to wait 5 business days, so a week. I can’t put the refill in any earlier.. in the old mail order days, I’d have the refills in 2-4 days! Weekends and holidays didn’t seem to slow things down one bit, either.
      Yeah, “so sorry, military”, but the medical conditions you wouldn’t see me/treat me for (and I didn’t have any other insurance then, due to being self employed) have led to permanent disabilities that require a lot of medication. We paid over $4000 out of pocket when my husband had his hips replaced, before he was 50, because his visits to sick call, when he was active, got him Motrin 800’s and no real care (his surgeon says the continual “humping” and running wore down his hips; he can no longer run and isn’t supposed to climb stairs). I honestly feel all of these changes are to get us old folks off their rolls, that we will just give up. I’m too stubborn, even taking 2 hours off work, the mornings I go to the pharmacy, every 3-4 weeks.
      Oh, and my pharmacy kept telling me, soon after the switch, that one of my prescriptions was coming from Express Scripts. ES said they had no record of us!! Back and forth, again neither willing to talk to the other, until I ran out of one of my “maintenance” meds and had to go to the hospital (2 1/2 hours) to get an emergency fill.. and, they counted that as another refill, so I got 1 fill and was charged with 2!
      Luck is surely what we need!

  • Nelson

    Thank you Amy. Your knowledge is very impressive and so helpful. Many blessings to you and your loved ones! What you are doing is amazing. Good luck ma’am

  • Jackie Wildasin

    Both my husband and I are on Lotrel for blood pressure. We have been told by express scripts that they cannot get it from the manufacturer or any of their suppliers. We currently go through a private pharmacy for this Rx. What are we to do now?

  • Dave

    I tried getting my wife’s medication filled thru ES on 2 separate occasions and both times were nightmares. As instructed by ES, the doctor’s office wrote “Dispense as Written, Brand Only and No Substitute” on the prescription b/c in the past, my wife had allergic reactions to 2 different generic-equivalent brands. When the prescription arrived from ES, they were, of course, a generic brand and when we called to get it fix it, on both occasions, the operator was dumbfounded that the generic was sent. My wife was now screwed b/c she had NOTHING to take in its place b/c ES took so long in sending us the wrong prescription. Luckily, we were able to go back to our local pharmacist, who after hearing our sob story, gave my wife a 2-week supply of the name-brand to cover her until this was fixed. As mentioned, this happened on 2 occasions with ES so now I’m thinking what is going to happen when we are forced to go thru them as of 1 Oct (b/c MTFs do not carry name-brands) and ES sends us the generic again? Talk to the dumbfounded operator and pay the $700 out of pocket each month? Does anyone know something that I don’t on getting the name-brand that can help us out?

  • MGates

    This is all about government control folks. I have long ignored those letters each month from Express Scripts suggesting that I use their service to make my prescription refills so much easier. But what I know is that they want to take control of my refills so that they can decide which brand I receive. When the pharmacy is working for me (ie Walmart, Target, CVS, etc.), they’ll work diligently with me to convince Tri-Care (the government) to get me what I need. This is TriCare’s way of forcing this down the throats of their consumer’s. What other medical insurance requires you to use their own pharmacy to fill your prescriptions? I am not looking forward to this change and just may pay for my own scripts to avoid it. Luckily, mine aren’t very expensive.

  • I am an independent pharmacist. I have patients nearly every single week tell me how they hate dealing with mail order. If you haven’t had that experience yet, allow me to give you a preview of some things to come.

    1. If you ever, sorry, when you have an issue with a prescription or want to ask a question, you will be on hold, and there’s no telling how long that will be. Not to mention the fact that you will never speak to the same person twice.

    2. You will not always get your prescriptions on time. This is perhaps the most common complaint I hear from my mail order patients.

    3. You will have more medication than you need. This may not sound like a problem at first, but wait until they continue charging you for prescriptions that you no longer take or that you have too much of. Good luck trying to get them to stop sending it. The whole point of you being forced to use mail order is to save the gov’t money but Express Scripts (TRICARE’s pharmacy benefits manager) is about as wasteful as you can be. And believe me, it’s not accidental that they do this. They get rebates from drug manufacturers for including those brand name medications on TRICARE’s formulary so that when TRICARE does pay for the drug, Express Scripts gets to pocket the difference. So the gov’t doesn’t save money. They just make Express Scripts Richer. Read more about this here: http://www.theindependentpharmacist.net/insurance

    4. You will never again have a personal relationship with a pharmacist you know and trust but you will become very well acquainted with Express Script’s automated system.

    If this sounds miserable to you or you know all too well the inconvenience and misery caused by mail order, I highly recommend you consider changing those brand name medications to generics. Talk to your local pharmacist on how to get this done. If that is not possible, then look into getting a waiver from TRICARE. They are only issued under certain circumstances (emergencies and personal needs such as you live in a nursing home).

    For more information on this and similar topics, visit my website: http://www.theindependentpharmacist.net

  • Jerome begany

    What if I have a second insurance BCBS? Tricker policy says they have to be first, then tricker.

  • They let me know I would need to enroll with the surgery which was fine beside that the strategy can take longer than a week, sitting tight for courses of action and gaining affirmation of area.

  • Cat

    funny, as recently as 3 days ago, my “outside provider” was told the ONLY way I could fill a prescription from them was a hand carried, written prescription