WASHINGTON, D.C. – U.S. Sen. Sherrod Brown’s (D-OH) legislation to help military retirees and their families stop smoking has been included as a provision in the Senate’s National Defense Authorization Act (NDAA) for Fiscal Year 2016.
The Strong Lungs, Strong Lives Act of 2015 – inspired by the story of military veteran and Urbana resident Terrence Levesque – would ensure that military retirees and their families who are TRICARE for Life beneficiaries maintain coverage for FDA-approved smoking cessation prescription drugs. The provision would make a technical change to the NDAA to ensure that Medicare-eligible TRICARE beneficiaries are reimbursed for FDA-approved smoking cessation prescriptions to complement counseling and other smoking cessation efforts.
Levesque called Brown’s office when he realized his TRICARE would not cover the cost of any FDA-approved smoking cessation drugs. After his doctor prescribed him a smoking cessation medication to complement his smoking cessation counseling, Levesque, found that he was unable to get the cost of the drug covered through TRICARE..
“We should be making it easier for our nation’s veterans to quit smoking – not placing additional barriers in their way. 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 the tools they need to help them quit.”
“About two years ago my doctor told me about a drug that has met with a high success rate in helping people quit smoking,” Levesque said. “With today’s emphasis on preventive medicine I was extremely surprised to see that, because of an overlook in the law, the medicine was not available to retired military members who were also on Medicare. I contacted Sen. Sherrod Brown’s office and he and his staff immediately went to work to correct this problem.”
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 FDA-approved 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 reimbursement of FDA-approved smoking cessation drugs for our country’s retired service members and their families.
This legislation is endorsed by the American Heart Association, the American Lung Association, the American Public Health Association, the National Military Family Association, Partnership for Prevention, and Veterans of Foreign Wars of the U.S. (V.F.W.).