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The new TRICARE Retail Pharmacy (TRRx) program and uniform formulary requirements bring changes that are important to you as a provider. Below are some important points to remember when prescribing medications to TRICARE beneficiaries, as well as answers to some common questions.
Prescribe Generic
Always prescribe generic medications, when available, to TRICARE beneficiaries. It is Department of Defense (DoD) policy, and it saves the beneficiary significant costs in copayments. Generic medications work the same as their brand-name counterparts in dosage, strength, performance and use, and they must meet the same Food and Drug Administration (FDA) quality and safety standards.
If you feel that a brand-name drug (for which a generic equivalent is available) is medically necessary for a beneficiary, it is recommended that you receive authorization from Express Scripts prior to writing the prescription. If beneficiaries have questions about the safety and reliability of generic medications, refer them to the FDA Web site at www.fda.gov.
Obtain Prior Authorization
You must obtain prior authorization to prescribe certain medications. You can view a list of those medications on the Express Scripts Web site. Each medication has a corresponding Prior Authorization Request Form (also available on the Express Scripts Web site) that you must complete and submit to:
Express Scripts
ATTN: TRICARE Prior Authorization
P.O. Box 60903
Phoenix, AZ 85082-0903
Fax: 1-866-684-4477
Quick FAQs
Q. Do I need to write a prescription for diabetic supplies?
A. Yes, TRICARE beneficiaries cannot purchase these over the counter.
Q. Are injectable medications available through the TRRx program?
A. Some injectable medications are available through the TRRx program, others are not. To find out which injectable medications are available through TRRx, call 1-866-363-8779. If an injectable medication is not available, you must contact Humana Military at 1-800-444-5445 to determine how to obtain this medication for your patient. |
