HEIDELBERG, Germany — Americans awaiting mail-order medications from the U.S. might find a nasty surprise in their military post office boxes instead: a letter from German customs saying the meds have been confiscated.
After months of legal back-and-forth between U.S. military authorities and the German government, the government ruled that it’s illegal for people to receive refills of prescribed medications by mail at their military post office boxes, according to Army Col. Richard Jordan, executive director of Tricare’s Eurasia-Africa office in Sembach, Germany.
The German Ministry of Health in February affirmed that the practice is not covered by the Status of Forces Agreement, the legal framework for U.S. military-German relations, and violates German health and customs laws.
“Any medications, any health supplements, even things over the counter in the U.S. — any of that stuff is subject to import taxation or confiscation,” Jordan said. “It’s really thrown a monkey wrench.”
Beneficiaries have been receiving medications at their military post office boxes for some time in a “well-established” program, Jordan said, although he said it was unclear if the practice had been violating German law or whether there had been informal agreements to allow it.
German officials have now declared it unacceptable and stepped up enforcement, he said.
At the same time, Tricare has in the past two years increasingly encouraged its beneficiaries, such as retired military personnel, to have prescription drugs mailed to them as the drawdown in Europe has forced the closure of numerous U.S. military pharmacies and limited many drugs’ availability, Jordan said.
Further, he said, remaining facilities may not carry the needed drugs in their formularies, and not all drugs prescribed in the U.S. are available in Germany. “A counterpart is difficult to get sometimes,” he said.
At the same time, Jordan said, German authorities seem to be stepping up enforcement of customs issues. “Recently, they’ve gotten more aggressive,” he said. “Basically they’re saying, ‘Fix this.’ ”
According to a February statement of policy from Germany’s Health Ministry, made available by Johnson, “Members of the U.S. Forces are not entitled to directly receive pharmaceutical products not licensed in Germany via postal channels. Pharmaceutical products must be imported by agencies of the U.S. Forces.”
The statement said importing medications into Germany is possible under the Status of Forces agreement if it is done by agencies authorized to import and distribute the medications.
“To our knowledge, the U.S. Forces already have established agencies, which are entitled to receive pharmaceutical products (e.g. U.S. Army Public Health Command or the U.S. Army Medical Department),” the statement said.
Tricare and all U.S. Germany-based medical commands are working to resolve the issue, Jordan said. In the meantime, he said, those who live near a military health care facility should talk with their doctors about ensuring their prescribed drugs are on the list of medications the pharmacy carries and get their medications there.
Others, he said, might have to drive to Landstuhl Regional Medical Center to pick up prescriptions.
Still others could continue receiving their meds by mail and hope they never get a letter from German customs.
According to Tricare websites, getting medications through the mail is the least expensive option for its beneficiaries, who include military personnel, their dependents and retirees.
Jordan said the biggest concern was possible interruption of medication for those with chronic health conditions.
It was unclear how many people could be affected. “This does impact a number of beneficiaries across Germany with broader implications for a number of civilian personnel living in Germany and working for U.S. Forces,” Jordan said in an email.
It’s unclear, Jordan said, whether receiving prescribed drugs at military post office boxes has ever been legal in Germany, or whether there may have been “gentlemen’s agreements” in the past to allow it.
The medicines had been delivered from the U.S., like other mail, in military aircraft. But military aircraft have been directed to other missions, he said, and commercial flights whose contents may receive more scrutiny are now used instead.
Increased enforcement by German customs authorities may reach even further than medications. Jordan said he recently received a letter telling him he owed an import tax on four pounds of coffee his family mailed him.