Tricare Prime/adderall/new spouse - Military Benefits

AirmansPrincess · 10-27-2009, 09:25 PM

I am newly married into the AF and I now have tricare prime. I have been taking adderall xr for over 3 years. I don't know how this will work with my new insurance...so, do I have to go to an on base doctor? Will they give me generic? The generic gives me headaches... Is there a way to go to my regular doctor? Can I take a Rx from a regular doctor and fill it on base? I have NO idea how to even go about this...do I need to get my medical records from my doctor and bring them on base? Any help is much appreciated!

Victoria · 10-27-2009, 09:36 PM

According to this link, it is covered.

AllyssaM · 10-27-2009, 10:01 PM

You *might* have to see a Dr that covers Tricare & get them to write out a new RX for you. And if you tell them the genetic kind gives you headaches, they won't prescribe it to you. However, you may get away by just seeing if your pharmacy takes Tricare & switch your insurance with them. If it's an off base/non military pharmacy, you'll have a small fee.. If you want it to be completely free, you'll need to go on base.

BubMunkeyBles · 10-28-2009, 10:26 AM

Depends on the base and whether you have to be seen on or not. When I was on Prime I HAD to go on base, so switched to Standard so I could go to doctors I trusted. You may need to get a letter from your doctor sent to Tricare in order to get the actual formulary and not generic since Tricare always gives generic when one is available. You most likely will have to get the brand name off base and pay the fee ($9 or $22).

Look under Medical Neccesity- it gives the details on the brand name stuff.
http://www.military.com/benefits/tri...armacy-program

TRICAREWiz · 10-28-2009, 02:07 PM

You'll want to have your doctor explain to TRICARE's retail pharmacy contractor (Express Scripts, Inc) that the generic medication gives you headaches and that's why you need the brand name medication instead.

I say this because after reviewing information from your doctor, Express Scripts, Inc. will determine whether it is clinically required for you to use the brand name medication instead of the generic equivalent.

Also, if you want to continue being seen by your regular civilian doctor, you'll have to switch to TRICARE Standard. You have more freedom with TRICARE Standard, but the out-of-pocket costs are a little higher.

To get more information visit the TRICARE's Pharmacy Program Web page and the ContactUs Web page to call your regional contractor or a TRICARE Service Center.

Getting on the phone with a beneficiary counselor is best because they can provide you with information specific to your situation and tell you what your health options are.

I hope this helped and let me know if you need anything else.

10-27-2009, 09:25 PM	#1 (permalink)
AirmansPrincess Senior Member Join Date: Aug 2007 Location: currently SJAFB, Goldsboro, NC moving to RAF Lakenheath 3/2010 Posts: 341 Classifieds: (0) Activity: 1% Longevity: 37%	Tricare Prime/adderall/new spouse I am newly married into the AF and I now have tricare prime. I have been taking adderall xr for over 3 years. I don't know how this will work with my new insurance...so, do I have to go to an on base doctor? Will they give me generic? The generic gives me headaches... Is there a way to go to my regular doctor? Can I take a Rx from a regular doctor and fill it on base? I have NO idea how to even go about this...do I need to get my medical records from my doctor and bring them on base? Any help is much appreciated! __________________

10-27-2009, 10:01 PM	#3 (permalink)
AllyssaM Living our love song Join Date: Dec 2006 Location: 32nd Street (San Diego, CA) Posts: 2,299 Classifieds: (0) Activity: 20% Longevity: 49%	You might have to see a Dr that covers Tricare & get them to write out a new RX for you. And if you tell them the genetic kind gives you headaches, they won't prescribe it to you. However, you may get away by just seeing if your pharmacy takes Tricare & switch your insurance with them. If it's an off base/non military pharmacy, you'll have a small fee.. If you want it to be completely free, you'll need to go on base. __________________

10-28-2009, 10:26 AM	#4 (permalink)
BubMunkeyBles MilitarySOS Jewel Join Date: Feb 2008 Location: Me- Tampa, FL, DH- Aviano AB Italy Posts: 6,550 Classifieds: (0) Activity: 82% Longevity: 29%	Depends on the base and whether you have to be seen on or not. When I was on Prime I HAD to go on base, so switched to Standard so I could go to doctors I trusted. You may need to get a letter from your doctor sent to Tricare in order to get the actual formulary and not generic since Tricare always gives generic when one is available. You most likely will have to get the brand name off base and pay the fee ($9 or $22). Look under Medical Neccesity- it gives the details on the brand name stuff. http://www.military.com/benefits/tri...armacy-program __________________ Stephanie

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10-27-2009, 09:36 PM	#2 (permalink)
Victoria Senior Member Join Date: Aug 2006 Posts: 34,198 Classifieds: (1) Activity: 96% Longevity: 55%	According to this link, it is covered.

10-28-2009, 02:07 PM	#5 (permalink)
TRICAREWiz Junior Member Join Date: Sep 2009 Posts: 5 Classifieds: (0) Activity: 1% Longevity: 3%	You'll want to have your doctor explain to TRICARE's retail pharmacy contractor (Express Scripts, Inc) that the generic medication gives you headaches and that's why you need the brand name medication instead. I say this because after reviewing information from your doctor, Express Scripts, Inc. will determine whether it is clinically required for you to use the brand name medication instead of the generic equivalent. Also, if you want to continue being seen by your regular civilian doctor, you'll have to switch to TRICARE Standard. You have more freedom with TRICARE Standard, but the out-of-pocket costs are a little higher. To get more information visit the TRICARE's Pharmacy Program Web page and the ContactUs Web page to call your regional contractor or a TRICARE Service Center. Getting on the phone with a beneficiary counselor is best because they can provide you with information specific to your situation and tell you what your health options are. I hope this helped and let me know if you need anything else.