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TRICARE Ending Coverage of Nexium

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Starting on June 28, 2017, TRICARE will no longer include the drug Nexium in the preferred, or formulary, drug list, and it will no longer be available in military hospitals and clinics.

If you wish to continue taking Nexium, your doctor must submit a prior authorization.  If approved, you can obtain Nexium at the non-formulary price ($49 copay for up to a 90 day supply for Home Delivery or $50 copay for up to a 30 day supply via retail).  If medical Necessity is established by your doctor and approved, TRICARE will continue to cover the cost of Nexium, minus the $20 copay for a 90-day supply of home delivery and $24 copay for a 30-day supply via a retail outlet. For more information on TRICARE's formulary list, visit the TRICARE Pharmacy webpage.

Patients are currently being asked to switch to one of the following three preferred alternatives:

  • Omeprazole
  • Pantoprazole
  • Rabeprazole

If you wish to continue taking Nexium, your doctor must submit a prior authorization.  If approved, you can obtain Nexium at the non-formulary price ($49 copay for up to a 90 day supply for Home Delivery or $50 copay for up to a 30 day supply via retail).  

If medical Necessity is established by your doctor and approved, TRICARE will continue to cover the cost of Nexium, minus the $20 copay for a 90-day supply of home delivery and $24 copay for a 30-day supply via a retail outlet. For more information on TRICARE's formulary list, visit the TRICARE Pharmacy webpage.

For more information regarding brand, generic drugs and which drugs are on TRICARE’s formulary list please visit the TRICARE website

 

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