A cyber-attack is disrupting pharmacy services for TRICARE beneficiaries at civilian pharmacies and military treatment facilities (MTFs).
Members may face delays in getting their prescriptions at MTFs, while civilian pharmacies may ask you to pay the full, cash price for your prescription. However, this attack has not affected Coast Guard pharmacies. There is currently no anticipated timeline for resolving the cyber-attack, which is ongoing and directed at Change Healthcare (CHC), TRICARE’s electronic prescription claims processor.
Q1: Why is this happening? Was there a cyber-attack on our military?
A1: There was no direct cyber-attack on our military. On Feb. 21, TRICARE’s electronic prescription claim processor, Change Healthcare, was the victim of a cyber-attack, preventing U.S. military pharmacies worldwide from processing prescriptions electronically. Change Healthcare is a private company that processes electronic prescription claims for many health systems, including TRICARE.
Q2: Why are MTF pharmacies experiencing processing delays?
A2: Military pharmacies are experiencing processing delays since the attack disrupted the normal prescription processing workflow. They have switched to a manual process that may result in delays. In addition, non-formulary medications and medications requiring prior authorization may not be able to be processed during this time.
Q3: What does this mean for me and my family? How will I get my medication filled?
A3: That is dependent on how you receive your medications.
Q4: I have been getting prescriptions filled at a civilian pharmacy, but now I am being asked to pay cash for the prescription. What are my options?
A4: Coast Guard servicemembers and their families are encouraged NOT to pay the cash price if your civilian pharmacy can’t submit claims to TRICARE during this outage. Instead, work with your provider to have your prescriptions sent to an MTF pharmacy or the TRICARE Mail Order Pharmacy Program through Express Scripts. Active-duty family members who live near a Coast Guard pharmacy may be able to get their prescriptions filled there; see Question 5 below.
Q5: Can Coast Guard family members get prescriptions filled at Coast Guard pharmacies?
A5: TRICARE-eligible dependents of active-duty Coast Guard members may have their prescriptions filled at a nearby Coast Guard pharmacy during this outage. Your Coast Guard pharmacist will help you navigate any potential hurdles, such as medications not being available due to market shortages. Coast Guard pharmacies are not able to mail prescriptions to dependents.
Q6: If I wanted to change where I have a prescription filled, how do I do that and how much would it cost?
A6: Your current pharmacy can transfer your prescription to an MTF, civilian pharmacy, or mail-order. You’ll need to call your pharmacy and give them the contact info for the pharmacy you’d like to use instead (be sure to have that information ready ahead of time.) You must make the request for them to do so by contacting the pharmacy that has your prescription and telling them where you would like the prescription sent.
MTFs do not charge a co-payment for pharmacy services for members or dependents. If you are an active duty servicemember, you will continue to have $0 copays for covered drugs at MTFs, civilian pharmacies and TRICARE Home Delivery. Your dependents also won’t be charged a co-pay at an MTF pharmacy.
If you get your dependents’ prescription filled at a civilian pharmacy or through TRICARE home delivery, here are the co-pays you can expect:
TRICARE Home Delivery (Up to a 90-day supply)
Generic formulary drugs $13
Brand-name formulary drugs $38
Non-formulary drugs $76
Retail network pharmacies (Up to a 30-day supply)
Generic formulary drugs $16
Brand-name formulary drugs $43*
Non-formulary drugs $76*
For more details, see: Changes to your TRICARE prescription drug copayments in 2024 | TRICARE Pharmacy Program | Express Scripts (express-scripts.com)
Q7: If I have never had a prescription filled using TRICARE Pharmacy Home Delivery, how can I use it?
A7: TRICARE Pharmacy Home Delivery is easy to use. You have several options:
For more details, please visit: TRICARE Pharmacy Home Delivery | Health.mil
Q8: I already paid cash for a prescription filled by a civilian pharmacy. Is there any way I can get reimbursed?
A8: TRICARE beneficiaries are encouraged to NOT pay the cash price for their prescriptions at civilian pharmacies. If you have already paid cash for a prescription, you may submit a reimbursement claim by following the instructions at https://www.tricare.mil/pharmacyclaims. However, there is no guarantee that TRICARE will retroactively reimburse beneficiaries for these cash claims.
Q9: Who do I contact for further questions?
A9: Please contact your nearest Coast Guard pharmacist. See also CG Pharmacy location.
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