@funk I’m at a loss to explain the G7 sensor unavailability at a military pharmacy, whether here in VA or WA, should be the same formulary. I’m covered by Medicare/TFL, like you, and it should be the same coverage. If you go to the Tricare formulary (Open Enrollment - Pharmacy Benefit Plans) it used to come up as available, with the same cost structures as today. I just did it as a test and it came up as:
Military (MTF) Covered with limitations.
Uniform Formulary (UF)
Prior authorization ¶ required
Quantity limitations
The “Covered with limitations” is a link so click on it and it says:
Your plan provides coverage for this medication in certain situations. To determine if coverage is available, your doctor may request a coverage review by calling the toll-free number, 1-866-684-4488.
This medication is covered for a maximum of 3 sensors per 30 days at retail or if available up to 9 sensors per 90 days at Home Delivery or MTF.
To receive coverage, this drug must be approved through a coverage review . Your prescriber must request the review using either: 1) an electronic PA system or 2) a Prior Authorization form (PDF). Without this, you may pay full price for the drug at retail and it will not be covered at home delivery and/or the military pharmacy. Contact your prescriber to help you with this.
I’ve obtained by G6’s since diagnosis at DOD pharmacies, switched to G7s about 9 months ago with no problem. Prior Auth was not required when I started that I know of, never saw it on the link before now; the “quantity limitations” may be due to other than T1/2’s trying to get them and DOD was trying to restrict them (conjecture on my part). The PA can be taken care of by your PCP/Endo. Also, my understanding (see Is Dexcom CGM covered by Medicare? | Dexcom | Dexcom) Medicare covers G7 as well, so with both Medicare and Tricare coverage, the cost to DOD/TFL should be minimal. I recommend discussing with both your PCP/Endo and the pharmacist (not the clerk that may disburse scripts) at your military pharmacy.