In Advance Of Wednesday's Markup Of The National Defense Authorization Act For 2016, Sen. Brown Introduces Bill To Ensure Coverage Of Prescritions To Help Military Retirees And Their Families Stop Smoking

Many TRICARE for Life Beneficiaries Are Forced to Pay Out of Pocket for their Smoking Cessation Prescriptions

WASHINGTON, D.C. – In advance of today’s markup of the National Defense Authorization Act (NDAA) 2016 reauthorization, U.S. Sens. Sherrod Brown (D-OH) introduced legislation today to ensure that military retirees and their families who are TRICARE for Life beneficiaries would have access to FDA-approved smoking cessation prescription drugs that are also covered by their insurance. The Strong Lungs, Strong Lives Act of 2015 would make a technical change to the NDAA to ensure that Medicare-eligible individuals who also have TRICARE for Life insurance are able to obtain smoking cessation prescriptions to complement counseling and other smoking cessation efforts. This legislation is endorsed by the American Lung Association.

“Every person who wants to quit smoking should have full access to the resources needed to do so,” Brown said. “The current gap in coverage has made it difficult for Medicare-eligible TRICARE beneficiaries to access medicines that can help them quit smoking. We should be making it easier for our nation’s Veterans to quit smoking – not placing additional barriers in their way. This bill will help ensure that TRICARE for Life insurance is fully serving the needs of our service members, our veterans, and their families.” 

TRICARE is a health insurance program that serves as the primary source of health insurance coverage for many active duty service members, National Guard and Reserve members, veterans, and some military families. However, once TRICARE beneficiaries age into Medicare coverage, Medicare becomes their primary source of insurance and TRICARE fills in any gaps in coverage. Because TRICARE has a prescription drug service, Medicare-eligible TRICARE beneficiaries are often discouraged from signing up for Medicare Part D prescription plans.

In most cases, this wrap-around coverage works as intended. Medicare serves as the beneficiary’s primary source of insurance, and TRICARE fills in the gaps and covers necessary prescription drugs. However, there are a few services TRICARE for Life doesn’t cover that Medicare does, including reimbursement for smoking cessation prescription drugs. Although Medicare will cover smoking cessation counseling services for all Medicare-eligible TRICARE beneficiaries, these individuals are presently forced to pay for their smoking cessation prescription drugs out of pocket, since TRICARE is currently barred from covering the cost of these medications.

While these patients have access to counseling and other tools to stop smoking through Medicare Part B, many doctors recommend a multi-pronged approach to smoking cessation. The Strong Lungs, Strong Lives Act of 2015 would provide Medicare-eligible TRICARE for Life beneficiaries with comparable prescription drug coverage as Medicare Part D beneficiaries and ensure coverage of FDA-approved smoking cessation drugs for our country’s retired service members and their families.