Life - Health

Warriors at Peace

Combat veterans take refuge in yoga, discovering its ability to soothe and repair war-torn minds and spirits.

By Neal Pollack

Yoga Journal Magazine, August, 2010

In 2007 Samantha Lord was stationed in Iraq with her Army National Guard unit, assigned to some of the most stressful military police work imaginable. On some days, the communications specialist, who is also a sergeant, found herself driving top Iraqi government officials in a Humvee convoy. Constantly under threat of gunfire and mortar attacks, her nerve never wavered. "You can't mess up on those missions," she says. "They're no fail." She didn't mess up, but she did pay a price.

Her mind remained on high alert, even after she returned home to Massachusetts. Fourth of July fireworks made her run for cover. Plagued by memories of wartime driving, she was unable to drive her own car. There were times she felt she had to have a drink before she could even leave the house. Severe insomnia plagued her, and when she did fall asleep, she had nightmares of explosions, being shot at, or of her Humvee overturning. It was difficult to shed the feeling that every action had life-or-death consequences. "Even something like burning dinner," she says, "it's like you failed the mission."

Her experiences in the war were darkening her civilian life back home. "I felt severely disconnected from reality," she says. "No one here understands what I went through."

Lord attended therapy sessions at the local VA, or Veterans Affairs, center, which helped a little but not enough. The nightmares and paralyzing fears persisted. In October 2009, almost a year after she had returned from Iraq, Lord started practicing yoga with the There and Back Again program in Charlestown, Massachusetts. The teacher, Sue Lynch, understood what Samantha Lord needed, because she was a veteran herself.

"Yoga is calming," Lynch says. "You develop the ability to feel safe and in control, to be aware of what's going on. If you feel an intensity of sensation in your body, you can work with it. You don't have to take it on if it's overwhelming. Those types of cues in the practice translate to life off the mat."

Through yoga, Lord began to regain her confidence. She's also able to focus better. "I'm a much more even person," she says.

For active-duty military personnel, recently returned vets, and those who came back from the Persian Gulf or Vietnam decades ago, the problems associated with post traumatic stress disorder, or PTSD, can be intractable and crippling. But yoga helps soldiers deal with the effects of their wartime experiences. Thanks to yoga, many report feeling less anxiety, sleeping better, and having an easier time reintegrating into civilian life. In the past few years, yoga programs for vets, once almost impossible to find, have proliferated all over the country. Many programs were started by current or former military personnel, and in some cases, they're sponsored and funded by the military itself. "The military doesn't have a choice," says Sat Bir Khalsa, assistant professor of medicine at Harvard Medical School and director of research for the Kripalu Center for Yoga & Health and the Kundalini Research Institute. The military has to be open to it, Khalsa says, "because yoga may contribute to benefits above and beyond those provided by traditional therapies." To prove some of those benefits, Khalsa is conducting a 10-week study of yoga for veterans with PTSD, which is being funded by a Defense Department grant. The study incorporates postures, breathing techniques, meditation, deep relaxation, and more.

Regaining Calm and Control

While serving as an artillery-man in Iraq, Paul Bradley twice suffered concussions when the vehicles he was riding in turned over. After he returned to his former life as a Boston firefighter in 2006, a doctor at the VA diagnosed him as having a traumatic brain injury and PTSD.

Loud noises drove Bradley crazy. He had trouble remembering things and would fly into violent outbursts at the slightest provocation. He responded to everything the way a child would. "There was no thought process," he says. "I'd just react." To cope, he drank and lived, as he says, "the fast lifestyle."

Symptoms like Bradley's are common for returning veterans who suffer from PTSD, says Lynn Stoller, an occupational therapist who works with Yoga Warriors, a program for veterans in Massachusetts. With their survival dependent on hyper-vigilance at all times, soldiers at war basically reset their neurological patterns.

In regular daily living, the sympathetic nervous system, responsible for the "fight-or-flight" instinct, releases cortisol, the stress hormone, whenever the body senses danger. In wartime, when the body senses danger virtually all of the time, the sympathetic nervous system is cranked into permanent overdrive, and soldiers remain in that state even after they are out of danger. "When that self-regulatory mechanism gets distorted, then it's hard to regain it sometimes," says Bill Donoghue, a minister, yoga practitioner, and former Marine who counsels returning soldiers. "Yoga seems to be the simplest, least expensive, and most efficient vehicle for regaining that sense of calmness and control again."

Dave Emerson is the director of Yoga Services of the Trauma Center at Justice Resource Institute in Brookline, Massachusetts. He says that yogic breathing techniques are important for people who suffer from PTSD to learn.

Simple practices, like counting the out breath or doing alternate-nostril breathing, can make a difference. Quickly and simply, breath work replaces the fight-or-flight response with the relaxation response, a state of physiological relaxation, where blood pressure, heart rate, digestive functioning, and hormonal levels return to normal.

Returning soldiers, says Donoghue, have already experienced the powerful way that controlled breathing can focus and redirect the mind, even if they've never heard of pranayama. "An integral part of centering on your target is controlled breathing. So Marines can relate to that concept. They just haven't used it, except on the firing range."

Bradley, after struggling with PTSD for several years, saw a flyer in 2008 at the VA center for a There and Back Again yoga course. After just one class, "I left more centered and relaxed," he says. "From there, I just got hooked on it. It's what worked on me. Since I'v e started yoga, I've gotten more productive. I started seeing a counselor again. I'm able to talk about my problems, whereas before, I wanted nothing to do with it. It seems like I'm not as angry after I do yoga. I'm able to function more in regular life."

A Deeper Peace

An inability to get to sleep is one of the most common problems that returning soldiers face. A hyperactive nervous system simply doesn't allow a body to shut down for the night.

Hugo Patrocinio, a 27-year-old Miami resident, served eight years as a Marine infantry man, including two tours of duty in Iraq. He was getting ready to go back for a third time when he was diagnosed with PTSD. He could sleep only with the help of heavy prescription medication. Psychotherapy didn't help. Then he took a yoga class. Within the first 10 minutes of the class, after some breathing exercises and instruction to let the mind drift away, he fell asleep. The teacher let him sleep the entire time. "When the class was over, I finally felt like I'd had some rest," he says.

Yoga may help returning service members get temporary relief from insomnia, but it can also, if practiced regularly, imbue them with a deeper sense of mental calm, so they can reestablish normal sleep patterns. Patricia Lillis-Hearne, an active-duty military doctor in Maryland, spent a year in Iraq. When she came home, she found herself suffering from neurological problems similar to her patients'. "Even though I'm a doctor and I'm supposed to be older and wiser, I wound up coming back with a certain amount of baggage of my own," she says.

She had trouble sleeping and suffered from intractable migraines that would last up to a week. Her doctors put her on two medicines to prevent them, and two other medicines to repress the symptoms. When they added a Percocet prescription for the migraines, Lillis-Hearne, who'd practiced hatha yoga on and off for years, decided she had to try something else.

One morning, while seeing her daughter off to school, she met a neighbor, Karen Soltes, at the bus stop. Soltes taught yoga, specifically, a practice called Yoga Nidra. "When I went to try the class, I went to get two blocks and a strap and I saw everyone else getting a bunch of blankets," she says. "That's when I knew this would be different."

Military Protocol for Yoga?

Yoga Nidra, or yogic sleep, is one of the four states of mind described in the Yoga Sutra. It's not sleep as we traditionally know it, but rather a state of conscious sleep used for deep relaxation and subtle spiritual exploration. Richard Miller, a clinical psychologist, yoga teacher, and president of the Integrative Restoration Institute in San Rafael, California, has developed a protocol for the military, based on the techniques of Yoga Nidra, that is in use at Walter Reed Army Medical Center, in Washington, DC; the Miami and Chicago VA hospitals; and Camp Lejeune in North Carolina. Miller says he designed the program to help returning soldiers find "a place of well-being that was never wounded."

Miller's program is a 35-minute guided meditation, initially learned lying down, and then integrated into all body positions. He incorporates breath awareness and "body sensing" but goes beyond that, asking participants to observe their emotions, thoughts, and memories from an objective distance. It introduces the yogic concept of the observing Self, something beyond body, mind, and spirit that never changes, regardless of thoughts, emotions, or experiences. This is referred to as purusha, though Miller deliberately left yoga and Sanskrit terminology out of his program. At the military's suggestion, he renamed it iRest.

It can be tricky to impart this esoteric brand of yoga thought to a military population that has seen and experienced terrible things beyond ordinary imagination, says Soltes, who teaches the iRest protocol at the Washington, DC, VA Medical Center. But through this practice, she says, soldiers learn that they are more than all these things. They have these thoughts and feelings and images, but they learn to remember that there's a part of them that's never been touched by trauma. It's still whole, it's still healthy, and it's still intact.

Yoga Nidra may sound like an odd fit for VA hospitals, but it's finding enthusiastic quarter in a military medical establishment dealing with a huge and growing population of traumatized soldiers returning from a nearly decade long war. Nisha Money is a preventive-medicine physician for the U.S. military, who is helping to integrate programs such as iRest (Yoga Nidra) protocols as an adjunctive therapy for post traumatic stress disorder. She says that soldiers with PTSD respond well to the practice because it draws on internal resources during the stress of military life and post battle trauma-related disorders.

"Much of military training involves re-assembling the internal mental structure to become a warrior," Money says. "As a result, a typical soldier is more inclined to have a beginner's mind. It opens up the awareness that you don't know everything, and that you'll have to be open to new ways of being."

After her first class in the Yoga Nidra program, Lillis-Hearne started sleeping better. "By the second class, I knew I was at home," she says. Very gradually, her headaches became more manageable. She dropped her medications. Much more quickly than she'd expected, she went from pain and confusion to a state of feeling calm, centered, and whole. Within a few months, she was training to be a Kripalu instructor herself.

"In a million years, I never thought that I'd be teaching yoga," Lillis-Hearne says. "But what it did for me was so incredibly profound that I really wanted to share it in any way I could, and in particular with a group of people who ordinarily would never enter a yoga studio."

Sensitivity Training

Anu Bhagwati is a former Marine captain and the executive director of the Service Women's Action Network, an advocacy and direct-services organization for service women and women veterans. During her second year in the Marines, she took a two-week leave to study at the Sivananda Ashram Yoga Ranch in Woodbourne, New York, an experience she calls "a total mind warp, because I was very much militarized at the time." Then she returned to military service and promptly dropped her yoga practice.

When she left active service, Bhagwati found herself diagnosed with PTSD and depression. At her lowest point, her mind became "a dark and depressing place," and thoughts of suicide lurked close to the surface. She decided to do yoga again, she says,"because it worked when I'd done it before. It was natural, free, and good. I tell people it saved my life." This time, she took her practice further and became a certified yoga teacher. Now she gives a thrice-weekly class to veterans at the Integral Yoga Institute in New York City. She doesn't feel the need to give her classes a hard edge.

"People who want to 'boot-camp-ify' their yoga haven't been in the military," Bhagwati says. "I heard of one group that advertised their yoga classes as 'blood, sweat, and tears.' Is that what you want to give the military community? They've got that already. Wouldn't it be OK to just learn stress-management techniques?"

Classes for vets often have a different look and feel: Students might face the door, to avoid the anxiety that comes with thinking someone might come in unseen, and they usually don't hear a lot of esoteric ideas. Washington, DC-area yoga teacher Robin Carnes, who teaches iRest at Walter Reed's program for patients with acute PTSD, says, "I never Om with my students. Why put that barrier in the way?" She also avoids the word "surrender" and doesn't call Savasana "Corpse Pose," so as not to upset her students.

Karen Soltes says the practice often brings out a side of the soldiers that has long been repressed. "Sometimes there's this very tender openness to life," she says. "They're not on some kind of spiritual journey. They just want to feel better. They come to it with innocence and no preconceived notion about what it should be. It's almost like they get out of their own way." Bill Donoghue says that the nature of military life can actually leave returning soldiers more open to a transformative experience than civilians are. "It can be a life-changing experience, sometimes for the better."

That's what happened to Paul Bradley. Since he's taken up yoga, he's experienced a spiritual connection that had been absent even before he went into the service. "Yoga brought spirituality into my life. I had no spirituality before. And after, I was just trying to get through the night and forget what I saw in the war."

An Army of Yoga Teachers

Yoga has had such a profound effect on vets returning to their civilian lives that many of them want to spread the word. Sue Lynch, a military lawyer, was once on the receiving end of a missile attack while serving in Saudi Arabia in 1990. When she returned home to Boston, she thought she had it together, but PTSD struck her hard. Depression and anxiety made her daily life almost unbearable, and therapy offered little relief. "A studio opened nearby—I started practicing and said, 'Oh my god, that's it!' " She became a yoga teacher, and now, through her organization, There and Back Again, she is training returning soldiers to teach as well.

Bradley, the Boston firefighter, is going through Lynch's training because he wants to bring classes to the rough streets of Charlestown. Patrocinio is taking regular trips from Miami to go through training sessions in Boston as well. "In many ways, it helps you reconnect," he says. "There's a lot of anger and numbness, emotions and feelings because of the situations you were put into in combat. Yoga teaches you how to live the moment, how to accept the past, and even let it go. When I first started doing yoga, I didn't realize these things. But it's been very helpful."

Ten Tips to Help You Lose Weight 

 By Maj. Karen E. Fauber, DeCA dietitian

             FORT LEE, Va. – The new year is here and you are off and running with your resolution to lose weight. Tennis shoes in one hand and water bottle in the other, you are going to lose those five, 10 or more pounds this time, right? Well, to help you reach your individual weight loss goal try these tips and the pounds will melt away:

  1. Be real. Set a realistic goal for weight loss and write it down. Losing two to no more than three pounds a week is generally recommended by the experts. Remember how long it took to gain the weight? Give yourself time to lose it gradually and you are more likely to keep it off as you change your lifestyle habits.
  1. Feel the burn. Calories in, calories out or what you eat is what you get. This means be active. Go walking, swimming, jogging, bicycling and dancing to burn those calories. The key is to make physical activity a part of your everyday life.
  1. Go small. Use the small plate and small bowl at meals instead of the large ones. It is too easy to eat too much when you use a big dinner plate or a large bowl, especially for that nighttime ice cream.
  1. Eat fiber. Aim for 25 to 35 grams of fiber a day. Fiber fills you up and helps you feel full for a long time between meals. Easy ways to get more fiber include eating cereal for breakfast that has 10 or more grams per serving, eat a pear or an apple for a snack, add beans to your meals, soups, and salads, and add a few nuts as a snack or on a salad.
  1. Got protein? Do not skimp on protein; this includes chicken, fish, turkey, lean beef and pork. It also includes dairy foods like skim milk, yogurt, low fat cheeses, beans and nuts, all found in your commissary at savings of 30 percent or more. The average person needs .8 grams protein per kilogram body weight, about 60 to 90 grams protein a day. 
  1. Is that plate big enough? Portion control, portion control, portion control. A serving that is bigger than your fist is probably too much to eat – unless it’s vegetables.
  1. Mama said, “Eat your veggies!” And, mama was right. Eat vegetables at lunch and dinner. Portions are not so important here. In fact, eating vegetables is a good place to cheat if you need to. Make sure to fill up half your plate at meals with vegetables. The fiber, water content and nutrients in vegetables helps the body lose weight. Fresh, canned, or frozen veggies are all great choices. Avoid the sauces, though, as they add many extra calories.
  1. Don’t forget the fruit. Fresh, canned or frozen: they all make great snacks and a nice desert. Dried fruit is OK, too, as long as you control the portion sizes. 
  1. “I get by with a little help from my friends.” Get support to stay on track with your weight loss from your family and friends. How about creating your own biggest losers contest and invite others to join? Support goes along way with weight loss.
  1. Celebrate your progress. Give yourself a pat on the back and more as you continue to lose weight. It’s no easy task. As you reach a weight loss goal how about something special to reward yourself? Make it something that you really can enjoy like a new outfit, season tickets for your favorite sport, a special vacation. You decide what it is and write it down with your goal. 

       See you in the commissary!

       For more information on weight loss or other nutrition topics, go to the DeCA Dietitian Web page at

Alcohol and Drug Rehabs


Manage pre-diabetes to help delay or prevent diabetes

          FORT LEE , Va. – Diabetes affects nearly 21 million Americans with its many health risks and complications. One in every four Americans has diabetes or is at risk for developing it. Before people develop Type 2 diabetes, they almost always have pre-diabetes, according to the American Diabetes Association. During American Diabetes Month in November, remember to talk with your health care provider about diabetes testing, prevention and treatment.

            Pre-diabetes is very similar to diabetes. Blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes. Research has shown that some body organs, including the heart and blood vessels, may already be damaged during pre-diabetes. Research also shows that if you manage your blood sugar when you have pre-diabetes, you might be able to prevent developing diabetes.

            Diabetes is more common among blacks, Latinos, American Indians, Asian Americans, and Pacific Islanders. There is also an alarming trend in children and teenagers developing diabetes. This has been linked to the increase of overweight children and an overall lack of physical activity in young people today.

 How to manage pre-diabetes

            One way to help prevent or delay diabetes is to get tested early. You can get a blood test, the fasting plasma glucose test, or an oral test, the oral glucose tolerance test, through your doctor. These tests are also used to identify diabetes.

            Nutrition plays a key role in warding off diabetes. Eat a healthy diet with the foods you buy at your local commissary and follow these guidelines:

·                                 ● Eat lots of fruits and vegetables every day

·                                 ● Control portion sizes

·                                 ● Eat fish two to three times each week

·                                 ● Eat whole grain breads and foods

·                                 ● Eat beans with meals

·                                 ● Eat less high-calorie snack foods like ice cream

·                                 ● Drink calorie-free drinks and water

            Regular physical activity including strenuous exercise also can help lower blood sugar and reduce weight, two chronic issues with diabetes. Break out your walking shoes and walk every day for 30 to 60 minutes. Add other physical activities to help prevent or delay diabetes.

            See you in the commissary!

            For more information on diabetes or other nutrition topics, visit, post your questions on the “DeCA Dietitian Forum” and be sure to look for other useful information in the “Dietitian’s Voice” archive.

  Bush Introduces Commission to Review Military Health Care

     In order to ensure that troops get the best care, Bush introduced a new bipartisan presidential commission that will review servicemembers’ health care. “This review will examine their treatment from the time they leave the battlefield through their return to civilian life as veterans, so we can ensure that we’re meeting the physical and mental health needs involved,” Bush said. The commission, headed by former Sen. Bob Dole and former Health and Human Services Secretary Donna E. Shalala, currently president of the University of Miami, will conduct a comprehensive review of military medical care. Meanwhile, a separate task force will assess short-term needs, Bush announced. Story

Tricare Information Now Housed Under One Internet Roof

American Forces Press Service

WASHINGTON, Nov.  2006 – Tricare beneficiaries will get a pleasant surprise the next time they visit Tricare Online. The Web site has a new name, a new look and a new home. It’s now part of, the official Web site for all Tricare information.

“We reorganized the Web site with our beneficiaries in mind,” said Army Maj. Gen. Elder Granger, deputy director, Tricare Management Activity. “Now they can go to one site to look up benefit information, schedule an appointment or track claims. Everything’s in one place, making the site easier to use.” comprises five main content areas:

-- My Health (Tricare Online) -- personal health information and online appointment scheduling for Tricare Prime enrollees;

-- My Benefit -- Tricare benefit information;

-- MHS Staff -- resources for Military Health System staff members;

-- Tricare Providers -- information for Tricare network providers; and

-- Pressroom -- the latest news about Tricare and the military health system.

In the next phase of Web site improvements, beneficiaries will be able to enter their profile and receive benefit information tailored to them. Tricare expects this feature to be available in winter of 2007.

Related Sites:

Newest Vets Receive Priority for VA Medical Care

By Donna Miles
American Forces Press Service

WASHINGTON, Nov.  2005 The estimated 120,000 veterans of operations in Iraq and Afghanistan receiving medical care through the Department of Veterans Affairs are getting top priority as they access some of the world's best-quality medical treatment, the secretary of Veterans Affairs said.

R. James Nicholson spoke to American Forces Press Service and the Pentagon Channel in anticipation of National Veterans Awareness Week, which began Nov. 6 and continues through Nov. 12.

Although the wounded veterans of Operation Iraqi Freedom represent just 2 percent of the VA's total patient load, "it's a very important 2 percent because these are young people who have come back from the combat zone," Nicholson said.

As a result, the VA is "giving them priority and making sure we are taking care of their physical and mental needs" so they can continue to enjoy productive lives, he said.

Seeing the nation's young people return home from combat reinforces the message that freedom comes at a high cost, Nicholson said. "Freedom is not free, and they are paying the ultimate price," Nicholson said. "And so, they will be taken care of and given whatever (health care and related assistance) they need ... for the rest of their lives."

It's gratifying to watch the recovery these wounded veterans make, particularly when hearing many of them say they want nothing more than to return to duty with their units, Nicholson said.

But for those unable to do that, Nicholson said, the VA's responsibility is to help them see beyond their wounds and recognize that they can continue to live productive lives. "That's part of our mission, to show them all the things they still can do and not have them focus on the things they can no longer do," he said.

While the nation gives special consideration of its veterans this week, the VA continues its longstanding commitment to the nation's veterans year-round, Nicholson said. For the past 75 years, the VA has provided health services and other benefits to veterans, living up to the promise made by President Abraham Lincoln during his second inaugural speech: "To care for him who has borne the battle, and for his widow and his orphan."

Over its history, the VA has created the world's most comprehensive system of assistance for veterans, including what Nicholson described as "world-class health care." Some 237,000 VA professionals provide health care to more than 5 million veterans through 187 medical centers and 860 outpatient clinics.

A computerized medical record system -- one Nicholson said he hopes will serve as a model for the Defense Department and other organizations -- helps eliminate hospital mix-ups and ensures more thorough patient care, he said. In addition, VA remains a leader in medical research, from studies involving Parkinson's disease to a recent breakthrough in immunizations for shingles, he said.

Nicholson said Congress and the Bush administration have demonstrated through increased funding for VA health care that they remain committed to ensuring veterans receive the top-quality services they deserve. VA funding has increased more than 50 percent since 2001, he noted.

"Veterans of every era can rest easy knowing that access to what has been described as the finest integrated health care system in the country will remain undiminished -- especially for low-income veterans, those with service-connected disabilities (or) special needs or who have recently returned from combat," Nicholson said.

R. James Nicholson

Related Site:
Department of Veterans Affairs

DoD Begins Tricare Retail Pharmacy Program June 1

       The Department of Defense announced today that tthe new Tricare Retail Pharmacy (TRRx) contract takes effect for Tricare beneficiaries located in the 50 United States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands and Guam.  The contract, awarded last year to Express Scripts Inc. of Maryland Heights, Mo., has approximately 53,000 civilian pharmacies in the nationwide network. 

      In the past, the Tricare regional managed care support contractors provided retail pharmacy services and most beneficiaries should not notice the change in services with the new contract.  To use the new retail pharmacy program, as with all other DoD health programs, beneficiaries must be eligible and enrolled in the Defense Enrollment Eligibility Reporting System or DEERS. 

        “The new single contract integrates the previous regional contracts into one uniform retail pharmacy benefit across all Tricare regions,” said Army Col. William Davies, director, DoD pharmacy programs. 

       The TRRx program has many new enhancements.  Pharmacy claims processing is now centralized and beneficiaries no longer have to mail pharmacy claims to multiple sites for processing or call various telephone numbers to get assistance filling a prescription when using the retail network.  Patient safety has also been enhanced by use of the Pharmacy Data Transaction Service to process all pharmacy claims, including paper claims. 

        For a single co-payment of $3 for generic or $9 for a brand-name prescription, eligible TRRx beneficiaries may continue to receive a 30-day supply of their prescription medication from the new network of retail pharmacies.  To use this benefit, a written pharmacy prescription and a uniformed services identification card are required.  Tricare beneficiaries who used a retail pharmacy last year will receive, by mail, a pharmacy identification card, a TRRx benefit guide and a letter listing the twelve network pharmacies close to their home. 

        The TRRx benefit is now portable.  Beneficiaries traveling outside of their designated Tricare region who need to fill a prescription are no longer required to pay the full prescription price, or file a Tricare claim to get reimbursed for their out-of-pocket expenses when they use a Tricare retail network pharmacy.  Pharmacy co-payments are the same in every location where the TRRx is available.  

         To locate a network pharmacy, beneficiaries may use the Tricare pharmacy locator service available on the Express Scripts Web site at, or they may call (866) 363-8779 or, using the letters on the telephone keypad, spell (866) “DoD-TRRx.” 

        For eligible beneficiaries with other health insurance (OHI), Tricare pays after all other insurance plans have paid.  To use Tricare as the secondary payer or to obtain reimbursement for their out-of pocket pharmacy expenses, beneficiaries will need to submit a Tricare claim form (DD Form 2642) and a receipt for their prescription medication to Express Scripts for processing.  If the medication under the beneficiary’s OHI is not a covered benefit or if the beneficiary’s prescription coverage has ended for the year, Tricare will pay as the primary insurance payer.

        The TRRx benefit is not available for beneficiaries who reside or travel outside the U.S. or its territories.  These beneficiaries are encouraged to use a military treatment facility, if available, or the Tricare Mail Order Pharmacy program to fill their prescription medications.  Express Scripts can mail prescription medications to any U.S. postal address or to an APO/FPO address.  However, Express Scripts cannot send prescriptions to a private, foreign address.  Prescriptions mailed to beneficiaries in overseas locations must be prescribed by providers who are licensed to practice in the United States.

        A downloadable Tricare claim form is available on the Express Scripts Web site at or on the Tricare Web site at  Pharmacy claims filed with Express Scripts should be mailed to:  Express Scripts, P. O. Box 66518, St. Louis, Mo., 63166-6518.

       Beneficiaries residing in overseas locations, other than Puerto Rico, Guam and the U.S. Virgin Island, do not have access to Tricare retail pharmacy networks.  Therefore, they must pay for their prescription medications upfront and submit a claim with Tricare overseas claims processor to be reimbursed.  For reimbursement rates or assistance processing a non-network overseas retail pharmacy claim, beneficiaries may contact the overseas Tricare Service Center at .


Drug Costs

All in One Medicine Directory

Military Hospitals


Dietary Guidelines for Americans


All Fitness

World Fitness 

Family Health

Women's Health

Men's Health

Kids' Health


 Canadian Pharmacy 
Save up to 80% on Prescriptions Drugs From Canadian Pharmacy Link. Get your Medications From Canada drugstore



Health Issues   





© Partnership Marketing Inc.
No Endorsement Implied