TRICARE Limits Refills of Some Inhalers

4/10/2020

Update: as of July 10, 2020

TRICARE is removing temporary quantity limits on inhalers and restoring pre-COVID-19 limits. Patients with asthma and other conditions can now get up to six inhalers at once for a 90-day supply at participating pharmacies.

If you get your medications from:

The covered brands include:

  • Albuterol
  • Levalbuterol
  • Proair
  • Proventil
  • Ventolin
  • Xopenex

If you have asthma or another respiratory condition, you may be familiar with albuterol and levalbuterol inhalers. Albuterol is also known by the brand name ProAir, Proventil, and Ventolin. Levalbuterol is also known by the brand name Xopenex. Because of COVID-19, the demand for these two inhaler drugs is now much higher than normal. In response to the high demand, TRICARE is implementing quantity limits on these two drugs. 

Beginning April 10, you’ll receive only one inhaler per 30 days. The decision to impose quantity limits is in line with guidance from multiple nationwide health systems and organizations like the American Medical Association. This will help balance the demand with supply to ensure all patients have access to these medications. 

“Our goal is to provide you with the prescription drugs that you need,” said Air Force Col. Markus Gmehlin, chief of the Pharmacy Operations Division at the Defense Health Agency. “We must be good stewards of health care resources during this national emergency.” 

Do you still have refills available? If so, you can get a refill starting on or after the 22nd day after you get your prescription filled. A pharmacist can give you more than one inhaler, if medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition..

At retail network pharmacies and TRICARE Pharmacy Home Delivery, you’ll pay your copayments as usual. This means one full CopaymentA fixed dollar amount you may pay for a covered health care service or drug. applies for each inhaler. Your inhaler may come in generic, brand name, and non-formulary form. For example, albuterol is available in generic form. This means you’ll pay $10 for one inhaler through home delivery. At a retail network pharmacy, you’ll pay $13 for one inhaler. There are no copayments if you use a military pharmacy. You’ll have a higher copayment for brand-name or non-formulary inhalers. You can check the TRICARE Formulary Search Tool for the cost of your medication. 

“We’re monitoring the availability of these medications on a daily basis,” said Gmehlin. “We will remove the quantity limits as the supply of these medications becomes available. All manufacturers of these products are increasing production levels to meet this increased demand. There are no current long-term shortages projected.”

Do you have additional questions? You can:

If you reasonably think you have a medical emergency, call 911 or go to your nearest emergency roomThe hospital department that provides emergency services to patients who need immediate medical attention..

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Last Updated 7/14/2020