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ASHP Requests Changes to Tricare Co-Payment Structure to Limit COVID-19 Exposure Risk

Chairman Inhofe, Ranking Member Reed, Chairman Smith and Ranking Member Thornberry

March 27, 2020

The Honorable James Inhofe 
Committee on Armed Services
205 Russell Senate Office Building 
Washington, DC 20510

The Honorable Jack Reed
Ranking Member
Committee on Armed Services
728 Hart Senate Office Building
Washington, DC 20510  

The Honorable Adam Smith 
Chairman Committee on Armed Services 
2264 Rayburn House Office Building 
Washington, DC 20515

The Honorable Mac Thornberry
Ranking Member
Committee on Armed Services
2208 Rayburn House Office Building
Washington, DC 20515

Dear Chairman Inhofe, Ranking Member Reed, Chairman Smith and Ranking Member Thornberry:

Military Treatment Facility (MTF) pharmacies are high-traffic areas. They are often congested with beneficiaries that include active-duty service members, retired service members, and their Tricare-eligible family members, as well as staff. With patients coming to pharmacies to obtain refills of prescriptions amid the COVID-19 pandemic, MTF pharmacies are becoming even busier and more congested than normal. This is exactly the opposite of effective social distancing. To protect service members, their families, and medical staff, we urge Congress to immediately waive copayments for Tricare mail-order prescriptions for the duration of the COVID-19 national emergency.

ASHP represents pharmacists who serve as patient care providers in acute and ambulatory settings. Our nearly 55,000 members include civilian and military pharmacists, public health service pharmacists, student pharmacists, and pharmacy technicians. For more than 75 years, ASHP has been at the forefront of efforts to improve medication use and enhance patient safety.

The Tricare pharmacy copayment structure, set by Congress, strongly incentivizes beneficiaries to fill prescriptions in-person at MTF pharmacies, rather than through mail-order options that reduce the risk of coronavirus exposure. There is a $0 copayment to fill prescriptions in-person at the MTF pharmacy, while many beneficiaries pay between $7 and $60 for each medication filled through Tricare’s mail-order pharmacy service. This copayment structure creates a strong incentive for patients to visit an MTF pharmacy, potentially exposing themselves, their families, members of our active-duty military, as well as military health personnel, to coronavirus. This exposure could be avoided by eliminating copayments for use of Tricare’s mail-order pharmacy during the public health emergency.

There have already been disruptions in pharmacy services due to pharmacy staff at Redstone Arsenal and Fort Eustis testing positive for COVID-19. It is critical that we protect our patients and staff at the MTFs and preserve military readiness by limiting COVID-19 exposure in MTFs.

While the active-duty pharmacy workforce makes up a relatively small amount of our total MTF pharmacy workforce, they make up 100% of our deployable pharmacy forces. This places our ready medical force at risk. MTF pharmacies are the primary source for maintaining medical readiness of our military when it comes to meeting their pharmaceutical needs. If COVID-19 infections or exposures in our MTF pharmacies remain unchecked, they will threaten the readiness of the active-duty force.

Congress should act now to protect active-duty service members, veterans, their eligible family member beneficiaries, and MTF staff by eliminating the TRICARE mail-order pharmacy copayment for the duration of the COVID-19 national emergency. This would remove the most significant barrier to reducing crowding in MTF pharmacies by shifting prescription volume to mail-order.

Thank you for considering this recommendation to protect members of our military, their families, and our military healthcare team.


Tom Kraus
Vice President, Government Relations

Vice President Mike Pence
Hon. Thomas McCaffery