ABILENE Texas (KTAB/KRBC)- As of Monday, October 24th nearly 15,000 community pharmacies nationwide will no longer be in-network for those using Tricare, the health care provider for those in the military and their families. While larger chains like CVS and Walgreens will continue to accept Tricare, some locally owned or small chain drug stores feel they have no other choice.
“We’ve never dropped an insurance company. This is the first time that that’s happened,” says Registered pharmacist Matthew Pennington of the James McCoy’s drug store in Abilene.
The change comes as a result of a recent contract between the Department of Defense (DOD) and Express Scripts, the Pharmacy Benefits Manager for Tricare. Express Scripts lowering the reimburse rate for filling a prescription at select pharmacies leaving pharmacists like Pennington with no room for profit when servicing Tricare patients.
“Basically every Tricare member, we’d be paying them 10 to 15 dollars a prescription just to get them their medicine and so, being a small business it’s just – you can’t keep your doors open,” said Pennington.
Which means his military customers will be left to find other means of filling their prescriptions at a reasonable cost, an outcome he never wanted to see.
“Dyess [Air Force Base] is huge we appreciate what those people do for our country and so it stinks that you’re not going to be able to take care of the people that are serving your country and protecting you to allow you to do what you love every day,” Pennington said.
Larger Chain pharmacies like Walgreens and CVS will continue to accept Tricare for now, though rural military families will have to fill their prescriptions on base, at the closest chain pharmacy. or by mail.
“If I need an antibiotic, I’ve got to drive 50 miles to Abilene and 50 miles back to get 10 days worth of medicine, and if I’m not able my son can go, but other old people they don’t have nobody,” said Tricare member Mary Mitchell of Stamford.
Mitchell’s pharmacy of choice in Haskell will soon be out of network. While Express Scripts offers medication by mail, Mitchell says that’s not always a viable option.
“If I’m sick enough to need an antibiotic, I don’t have have a week to wait for it to come in the mail,” said Mitchell.
Meaning families like Mitchell’s will be subject to a lack of accessibility in healthcare that they didn’t have before.
“Independent pharmacies are a huge part of the community because we’re hometown people. We’re here to take care of each other. We’re easily accessible. You’re taking out an integral part of the healthcare system that these people really count on,” said Pennington.
Pennington and Mitchell are calling others to action, asking them to voice their concern over this change in coverage in hopes of a different outcome.
“I urge people to contact their representatives – their senators their congressmen – and let them know that they’re upset about this,” Pennington said.
“We need to light up those phone lines and make them pay attention because they’re working for us,” said Mitchell.
Tricare has addressed the push back stating in an October 13th web article that they believe 90% of beneficiaries will have at least one network pharmacy within 15 minutes of their home.
National medical advocacy coalition Fight4RX is bringing attention to the change as well sharing the following newsletter with KTAB/KRBC.