At 69 years old, after decades in uniform and a promise of lifetime health care, I never thought I would have to fight the Pentagon for medications my doctor deems essential.
Yet the Defense Health Agency has terminated coverage of weight-loss medications for 2.5 million Medicare-eligible veterans in Tricare for Life — the Tricare plan for Medicare-eligible military retirees and their Medicare-eligible family members — while continuing to cover the exact same prescriptions for younger retirees.
This is not just unfair, it is unlawful.
In 2001, Congress ended decades of second-class treatment for older retirees with the creation of the Senior Pharmacy Program, guaranteeing Medicare-eligible retirees the same pharmacy coverage as younger beneficiaries.
Lawmakers also restored full Tricare eligibility for those enrolling in Medicare Part B. The intent was clear: Service members would no longer see benefits curtailed simply because they turned 65.
A governing statute — 10 U.S.C. § 1074g — reinforces that commitment by requiring a uniform formulary of covered drugs for all beneficiaries.
The Defense Department’s own 2002 rule was equally unambiguous, promising Medicare-eligible retirees “the same coverage for pharmacy services and the same requirements for cost-sharing and reimbursement.”
For more than 20 years, that promise held. When I turned 65, nothing changed: same formulary, same co-pays, same access. Until now.
DOD’s misreading
The Defense Health Agency now claims authority to deny Tricare for Life beneficiaries coverage for GLP-1 medications by invoking 32 C.F.R. § 199.17(f)(3), a regulation stating that treatment of obesity is covered under Tricare Prime and Select “notwithstanding” a statutory exclusion that applied to dependents in § 1079(a)(10).
The logic is tortured. First, § 1079(a)(10) governs dependent coverage, not retiree benefits.
The obesity exclusion was added in the 1970s to prevent the Civilian Health and Medical Program of the Uniform Services (CHAMPUS) from paying for elective weight-loss clinics for spouses and children, not to deny treatment to retirees themselves.
Second, DOD’s own regulation at § 199.17(a)(6)(ii)(C) flatly states that Tricare for Life is “unaffected by this section.”
In plain English: The regulation DHA cites does not apply to Tricare for Life.
Third, when Congress addressed obesity treatment in the FY 2017 National Defense Authorization Act, it did so by authorizing programs for all “covered beneficiaries,” not by singling out Prime and Select.
The Pentagon elected to implement that authority narrowly — it was not required. That choice cannot override a statutory command for a uniform formulary.
The human cost
This is not an abstract dispute. It is a matter of health and dignity for older veterans.
Without coverage, the monthly cost for me and every other retiree on TFL ranges from $499 at best to $1,349 at retail.
On a fixed retirement income, that is devastating.
Meanwhile, a 64-year-old retiree on Tricare Select pays a $35 co-pay for the same drug. The only difference between us is that I lived long enough to become Medicare-eligible.
And it is cruelly targeted. Older adults are more likely to suffer from obesity, less able to lose weight through exercise, and least able to absorb thousands of dollars in new drug costs.
Many suffer mobility issues caused by service-connected injuries. After decades of service, we now are asked to choose between essential medications and groceries.
The Pentagon’s misreading of its own rules cannot stand.
Congress should: Suspend the policy immediately pending review, investigate how DHA justified such a clear violation of statutory and regulatory text, clarify by statute that no drug on the uniform formulary may be denied to Tricare for Life beneficiaries if it is available to any other Tricare enrollee and require public accountability by compelling DOD to explain why it used a regulation that expressly excludes Tricare for Life to strip benefits from older veterans.
“Tricare for Life” was meant to be just that — for life. Not “for life with exceptions,” not “for life until you’re too old.”
The law promises uniform coverage for all beneficiaries.
By twisting a regulation, DOD has broken faith with those who served longest.
If the Pentagon believes these medications are too costly, it should seek new authorization from Congress — not engage in bureaucratic sleight of hand that punishes seniors.
Read the full article here
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