Tricare Rembursement for Pharmacy Charges

[JimGant]

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.

 

 

 

 

 

[FredLee]

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

[Pib]

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?

[JimGant]

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.....?

 

 

[kokesaat]

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!

[Pib]

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

 

 

    

[JimGant]

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....

[Pib]

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.

 

 

[Pib]

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. 

 

[JimGant]

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....

[FredLee]

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.

[USNret]

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/

[USNret]

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

[Pib]

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.

[Pib]

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

 

[TPUBON]

On 10/9/2019 at 1:40 PM, JimGant said:

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:

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.....?

 

 

I used Express Scripts to have my wife's meds sent to JUSMAG. It worked great. Took about one week and the best part was it was all US Mail. Shipping was free. Now that that option is gone, I have to rely on Thai mail. That is scary. My granddaughter sent a card to me at the beginning of September. Still waiting.

[JimGant]

2 hours ago, Pib said:

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

First off, yeah, 75% reimbursement after deductible taken.

 

Secondly, Tricare has no idea from the receipt about how many days supply there are...... I just ordered a nice round number, like for Bestatin, which comes 100 to the box (10 strips of 10 each). Exforge was the exception, where the pharmacist misunderstood the amount I wanted, but I didn't correct her, as it just means I buy fewer next time. So, Tricare has no precise way of knowing my number of days supply -- at one pill per day, for several of the meds, it's 100 days worth. Certainly no where near the 90day/30day precision wanted back in the States for Scripts TMOP, or for retail pharmacies.

 

So, who knows.... Do they keep count and thus prevent a reorder within 100 days? I guess I'll find out next time.

[JimGant]

23 minutes ago, TPUBON said:

I used Express Scripts to have my wife's meds sent to JUSMAG. It worked great. Took about one week and the best part was it was all US Mail. Shipping was free. Now that that option is gone, I have to rely on Thai mail. That is scary. My granddaughter sent a card to me at the beginning of September. Still waiting.

Thai mail won't work:

Quote

 *** TRICARE Mail Order Pharmacy ***

Effective 1 October 2019, the Air Force Post Office (APO) in Thailand CLOSED.

Regrettably, due to the APO closure, ordering prescription medication from the TRICARE Mail Order Pharmacy and having it delivered to an APO AP 96546 address has also ended.
>>>  TRICARE does not mail prescription medication to foreign addresses! <<<

http://www.jusmagthai.com/medical.html

 

[TPUBON]

On 10/10/2019 at 6:09 PM, TPUBON said:

I used Express Scripts to have my wife's meds sent to JUSMAG. It worked great. Took about one week and the best part was it was all US Mail. Shipping was free. Now that that option is gone, I have to rely on Thai mail. That is scary. My granddaughter sent a card to me at the beginning of September. Still waiting.

90 day supply

[moe666]

How long does it take to get reimbursed for a claim and do they send the money to your bank account in Thailad or the US.

[JimGant]

1 hour ago, moe666 said:

How long does it take to get reimbursed for a claim and do they send the money to your bank account in Thailad or the US.

I filed online with Tricare Overseas on Sept 7. Processing was complete on Sept 24, and money was in my US bank account on Sept 26. They direct deposit only dollars; and now that the ACH route through Bangkok Bank NY is essentially closed, there's no longer an avenue to have the Tricare dollar reimbursement sent to your Bangkok Bank account.

 

Quote

JUSMAGTHAI TRICARE Office Note #2:  Effective 1 September 2019 (originally 1 April 2019), TRICARE claim reimbursement via direct deposit to a Bangkok Bank account is no longer available.  Policy vs. Practice:  By policy, beneficiaries should not have set up their TRICARE claim reimbursements to be direct deposited to a non-U.S. bank like Bangkok Bank.  In practice, the direct deposits to Bangkok Bank were successful because the Defense Health Agency did not sort and block U.S. ABA routing numbers used by some foreign banks.  In short, that has changed due to a change in U.S. anti-money laundering rules that took effect 1 September 2019.  If you do not receive your TRICARE claim reimbursement via direct deposit to a Bangkok Bank account as expected, you now know the likely reason why

 

[TPUBON]

On 10/10/2019 at 6:34 PM, JimGant said:

Thai mail won't work:

 

That is correct but if the meds are mailed to an address in the US and then re-mailed to a Thai address, it will work. But as we all know, Thai mail is not the best.

[Pib]

2 hours ago, TPUBON said:

That is correct but if the meds are mailed to an address in the US and then re-mailed to a Thai address, it will work. But as we all know, Thai mail is not the best.

From review of USPS regulations the mailing of medications is only allowed from a DEA registered distributor (i.e., that is some company like Express Scripts, WalGreens, etc.  that fills prescriptions).  Now if a person is remailing meds to someone else....like someone in Thailand....well, if the mailer does not say meds are within the package then USPS or the Thai Postal System may never know unless the package is opened for inspection.  See below snapshot from USPS website.

 

Anyway, on 10 Oct I submitted/uuploaded my first Thai pharmacy reimbursement claim to Tricare as talked back in my 10 Oct post. I would expect this or next week it will be processed and I will know then how I faired. 

 

[Pib]

On 10/23/2019 at 11:27 AM, Pib said:

Anyway, on 10 Oct I submitted/uploaded my first Thai pharmacy reimbursement claim to Tricare as talked back in my 10 Oct post. I would expect this or next week it will be processed and I will know then how I faired. 

 

Update: My claim for meds processed today/28 Oct.  I billed Tricare for approx $33 in meds and Tricare allowed the entire $33. 

 

Now I'm <deleted> at myself for not doing this for the 11 years I've been in Thailand buying around $35/month in meds for me each month and another $15/month for the wife....totaling $50 total between us....that's $600/year.  I could have been getting 75% or $450 of that $600 reimbursed each year.  Over 11 years that adds up $4,950.   Oh well, live and learn.  

 

For my future claims I'm going to add some structure and schedule to what I get....do my best to buy a 90 days supply of my meds....get the necessary  receipt and file a claim.  And ditto for the wife...get 90 days worth of her meds....receipt...file a claim.  I going with 90 days since I think a 90 days supply is the max Tricare will reimburse as that also the max the Express Scripts, military hospitals, etc., will issue at a time.

 

 

[JimGant]

You're welcome. First two (three, four, five...) drinks are on you. Find an Air Force friendly bar for us old wild blue yonder geezers. ????

[TPUBON]

On 10/16/2019 at 10:52 AM, moe666 said:

How long does it take to get reimbursed for a claim and do they send the money to your bank account in Thailad or the US.

I just pay the co-pay. Mine is $7.00 - $24.00 depending on the meds. Other claims, for medical care in Thailand, took about three weeks to have the money deposited in my account in the U.S.

 

One person mentioned getting a years worth of meds. Tricare will only pay for a 90 day supply. You then have to have the prescription refilled. As far as buying meds here and getting reimbursed from Tricare, I haven't tried that.

[dlclark97]

1.  Sounds as if some people did not get the word about the APO closing.  It was announced approximately four months ago and there has been much discussion about it in the American communities and various media about how we were going to obtain our medications.  After many alternatives were researched, In the end it was decided we just have to live with obtaining meds locally.

2.  Also, there is more than one doctor here in Thailand who was able to write prescriptions for Tricare medications.  One I personally know of is at Mission Hospital in Bangkok.  An American doctor who comes from a military family and works very well with the retired and other military personnel.

3.  True, Tricare cannot ship to a foreign address.  And, even if they could the receiver would need an import license for some medications and there would also be customs duties.

4.  While a local pharmacy might be convenient, I get my meds at the hospitals where I see doctors, primarily Mission and BNH in Bangkok.  Never a problem about receipts or the pricing of my medications.  I file my Tricare claim via the internet and reimbursement is in my US bank in 2-3 weeks.  And, no worries about counterfeit meds.

5.  Some APO mail is still getting through to JUSMAG but if you receive your mail there, the very last day to pick it up will be 1 November (this coming Friday).  Mail received or on hand after that date will be returned to the sender.

6.  On the Tricare Overseas website it tells what is required on the receipts for your medications to be reimbursed.  And, they only pay for a 90 day supply at a time.  In some cases it may be possible to get refills without a doctors appointment if he/she knows in advance that you will be coming in for refills.  Something you would have to arrange with your doctor. 

[Pib]

On 10/28/2019 at 8:30 PM, Pib said:

Update: My claim for meds processed today/28 Oct.  I billed Tricare for approx $33 in meds and Tricare allowed the entire $33. 

 

For my future claims I'm going to add some structure and schedule to what I get....do my best to buy a 90 days supply of my meds....get the necessary  receipt and file a claim.  And ditto for the wife...get 90 days worth of her meds....receipt...file a claim.  I going with 90 days since I think a 90 days supply is the max Tricare will reimburse as that also the max the Express Scripts, military hospitals, etc., will issue at a time.

 

Update 2:  Above was a summary of my first attempted (and successful) Tricare reimbursement for maintenance medications bought here in Thailand. 

 

Earlier this month we (the wife and I) filed two more Tricare pharmacy claims....one for me....one for the her...claims number two and three.  These two claims represented a 90 day supply of our individual medications" as I wanted to get into a schedule of buying meds once every 90 days and submitting claims only four times per years for our maintenance meds.  Also I figure 90 days worth of meds is all Tricare would reimburse at a time.  Buying only a month's supply at a time and doing monthly claims would get old fast....yeap, doing 12 pharmacy claims per year for each of us would get old fast.

 

Anyway our two claims were for about $95 and $10, respectively.  Meds obtained from our local Thai pharmacy with same kind of receipt I described in my 9 Oct post #9 (different post than the one above).  Both claims were approved in full...claims took 15 days to approve.

 

So, three for three now in Tricare reimbursing pharmacy claims.  

 

[TPUBON]

On 10/10/2019 at 6:34 PM, JimGant said:

Thai mail won't work:

 

If it doesn't work, why was it delivered to my home in 11 days?

[Pib]

12 hours ago, TPUBON said:

If it doesn't work, why was it delivered to my home in 11 days?

But it was delivered to your Thai address after having it remailed from a US address, right?  I assuming so based on your 23 Oct response (below).   

 

On 10/23/2019 at 8:50 AM, TPUBON said:

That is correct but if the meds are mailed to an address in the US and then re-mailed to a Thai address, it will work. But as we all know, Thai mail is not the best.

 

And "remailing" prescription meds through the US mail is a no-no unless you are a DEA registered distributor.