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JimGant

Tricare Rembursement for Pharmacy Charges

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Posted (edited)

https://forum.thaivisa.com/topic/986822-tricare-overseas-program-pharmacy-claims/#comments

 

The above archived topic left me to believe I wouldn't have much success getting Tricare reimbursement for hand written pharmacy receipts. Nevertheless, I recently tried it. And low and behold -- Tricare accepted all items in full. So much for the guidance about what cannot be hand written on the submission.

 

 

 

 

 

633024832_pharmacybillcurtsept2019.thumb.jpg.24a76defedca6abedd4bdc60b71333bb.jpg

Edited by JimGant
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I have also never had a problem with a handwritten receipt. I always make sure they stamp the receipt PAID as an added precaution.

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Posted (edited)

Jim,

You didn't need to provide a doctors subscription also?...a US licensed doctor?

 

And did you use any special description on the DD Form 2642, Block 8a Description of Services?

Edited by Pib

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Pib, I only put the same info as the receipt on the DD Form 2642, namely: "Maintenance medications, quantity provided, blah blah."

And, as from post 17 in the above archived thread:

Quote

Indeed, the link provided says only prescriptions for mail order require a US licensed doctor. For fills at military facilities abroad, or non network pharmacies, the following applies:

"The prescription must be from an authorized, licensed health care provider." (And, as previously discussed, a licensed Thai pharmacist would appear to qualify.)

So, I guess a licensed pharmacist (or unlicensed -- who would know) can write a receipt like I got, without any doctor's name attached, nor daily dosage, nor without stipulated information, if even provided, need be "printed."

 

TOP is pretty loosy goosy, i.e., I've never had anything denied, both for medications and procedures. Nice! Maybe next time I'll save some travel time to the pharmacy and order a year's supply of maintenance meds..... (or, maybe not -- why push it).

 

Most of my meds, and my wife's, are cheap. But a few aren't -- so being able to file a pharmacy receipt buys a few more beers.

 

Interesting that JUSMAAG just put out the word about, with APO's going away, you no longer can get Express Scripts Tricare meds delivered to Thailand. Not sure who actually went that route, since such meds defintely needed a US doctor's prescription.....?

 

 

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JimGant, thanks for posting this.  The thread you referenced has some bad data....gives one the impression that only US doctors can prescribe meds.  Which is obviously not the case for anyone who has been going to Thai hospitals over the years.

I was not aware that you could get reimbursed for maintenance meds the way you have.  I'll mention it in our post meeting in Udon tomorrow.

Thanks again!

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Jim,

  Thanks.  Whenever I go to the hospital for some type of treatment where meds were also issued...like 30 days of some med....Tricare has always paid for those meds.  No problem there...the doc does not need to be a licensed US physician.

 

   However, never tried getting reimbursed for meds I just went to the Thai pharmacy to get....no subscription from the a doc (Thai or US)....like a maintenance med.  Never tried because of the requirement to include the "Prescription Number" and "doctor's DEA number (which only a US licensed doc will have)."   See snapshot below from the Tricare website listed below.  

 

   Obviously Tricare is not following their own rules shown below based on your receipt based on what can be handwritten, what can't, subscription number requirement, etc. 

 

https://www.tricare.mil/pharmacyclaims

image.png.00603f5ae5bd4d5811fadda1548394bb.png

 

 

    

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5 minutes ago, Pib said:

Never tried because of the requirement to include the "Prescription Number" and "doctor's DEA number (which only a US licensed doc will have)." 

Actually, the guidance doesn't say you must "include" prescription number nor doctor's name or DEA number -- it just says if you do include such info, it may be hand written.

 

Conversely, if you do include info such as date of fill, drug name, quantity, and amount paid -- it *should* be type written. But, I guess this isn't adhered to, at least in my situation -- and I'm assuming in Fred's too.

 

And, since Fred had success with hand written, let's hope this is the norm, and not a quirk....

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1 hour ago, JimGant said:

Actually, the guidance doesn't say you must "include" prescription number nor doctor's name or DEA number -- it just says if you do include such info, it may be hand written.

 

Conversely, if you do include info such as date of fill, drug name, quantity, and amount paid -- it *should* be type written. But, I guess this isn't adhered to, at least in my situation -- and I'm assuming in Fred's too.

 

And, since Fred had success with hand written, let's hope this is the norm, and not a quirk....

I don't know...I think the chart is saying the different things that must be on the receipt and which of these can be handwritten and which ones can't.  Example:  11 items of info required...of those 11, 5 can not be hand written but the remaining can.  And of course I"m sure they would prefer all items be printed with the exception of signatures.  But obviously based on the results of your claim that's not the case.

 

The next time I go to my pharmacy for one of my meds that costs like $25 for a month's supply, I will try to get a receipt resembling yours along with the standard cash register/credit card receipt given.  And then submit for reimbursement....see what happens....all Tricare can do is not allow the claim charges.

 

 

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I decided to do an early buy on two of my maintenance meds (approx 1000 baht worth)...and I wanted to see if I can get a detailed receipt from my primarily pharmacy. A receipt that include as much info as possible as required by the Tricare chart a few posts up.  

 

The pharmacy does not do hand receipts but they will provide a computer-generated Tax Invoice/Receipt which provides the majority of info in the Tricare chart.  It also includes my name and address.   But of course there is no Prescription Number, Doctor Name, or DEA number.  Pretty much every thing else is there.  The receipt is half Thai-half English...pretty much like my hospital receipts which Tricare is fine with.  I might even include a scan of the med boxes which shows the med name, specific drug, number of tablets, etc. 


I going to hand write in a few things which I think might clarify the buy, attached it to a DD Form 2642, upload it to Tricare and see what happens. 

 

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27 minutes ago, Pib said:

But of course there is no Prescription Number, Doctor Name, or DEA number.

Tricare will accept most RX sales by pharmacists in Thailand, as they are "licensed health care providers." As such, no doctor nor DEA number need be provided for these 'routine' medicines. However, I doubt you could get a controlled substance issued from a pharmacist without a doctor's prescription and DEA number. For such prescriptions, an alert Tricare would probably look for such info on the pharmacy receipt being submitted. But, for the normal maintenance meds we're talking about here, no such info required. At least that's my best guess....

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The first time I used an outside pharmacy instead of the hospital pharmacy I requested a prescription because I thought it was required by Tricare. Since then (7 years ago) I have never submitted a prescription, just a hand written receipt from the pharmacy stamped PAID. I have never needed a controlled substance, so I don't know in that case what would be required.

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If you're on Facebook, join this group which puts out lots of good info about using Tricare overseas.  Once you're in the group, you can join a 2nd one specifically about Tricare in Thailand. ** Edit (the link isn't working, but just search for "Tricare Overseas Program (TOP)" in FB.)

www.facebook.com/groups/TricareOverseasProgram/

Edited by USNret

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14 hours ago, Pib said:

I decided to do an early buy on two of my maintenance meds (approx 1000 baht worth)...and I wanted to see if I can get a detailed receipt from my primarily pharmacy. A receipt that include as much info as possible as required by the Tricare chart a few posts up.  

 

The pharmacy does not do hand receipts but they will provide a computer-generated Tax Invoice/Receipt which provides the majority of info in the Tricare chart.  It also includes my name and address.   But of course there is no Prescription Number, Doctor Name, or DEA number.  Pretty much every thing else is there.  The receipt is half Thai-half English...pretty much like my hospital receipts which Tricare is fine with.  I might even include a scan of the med boxes which shows the med name, specific drug, number of tablets, etc. 


I going to hand write in a few things which I think might clarify the buy, attached it to a DD Form 2642, upload it to Tricare and see what happens. 

 

Let us know how it works out

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1 hour ago, USNret said:

Let us know how it works out

Will do...uploaded claim to Tricare a few minutes ago.  Should know results in a few weeks.

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Jim,

What reimbursement percentage did you get for your meds?   I expect the standard 75% after your annual deducible was considered.

 

And were the meds you got a 30 day supply, 90 days, 6 months, etc., as I can't tell from your receipt? 

 

Also, did you somehow identify the supply period on the DD 2642 or somewhere else?   Seems Tricare says 90 days max.   For me, since the receipt didn't identity the supply period I mentioned it a 30 days supply on the DD 2642 since I wanted to point out I was not exceeding 90 days worth and also because I expect they keep a tally of meds submitted from earlier pharmacy claims. 

 

Snapshots of current Tricare Pharmacy Costs

image.png.bb535bd7949a744638f828642a35f3b9.png

 

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