TRICARE beneficiaries have prescription coverage under the TRICARE pharmacy program. Express Scripts administers the TRICARE pharmacy program. If your patient is not sure if they are covered by TRICARE, they can check their eligibility TRICARE.mil/Plans/Eligibility. Beneficiaries can fill their prescriptions through home delivery, the military hospital or clinic or a retail pharmacy.
The FST is a digital tool designed to educate users on medications covered under the TRICARE pharmacy benefit. When you search for your patient’s medication using the FST, you will see drug cost and fill options, any forms needed to process your patient’s prescription and coverage details.View now
Save time by sending prescriptions electronically to your patients’ choice of a local military pharmacy, home delivery through Express Scripts or retail pharmacy!
Prior authorization may be required from Express Scripts for some medications. Please direct beneficiaries to call Express Scripts at (877) 363-1303 for questions concerning home delivery and member choice support. Learn more
Military hospitals and clinics on bases/posts generally have their own pharmacy and offer the least expensive prescription option. E-prescribe is an electronic prescribing capability for civilian providers to send prescription orders directly to a military hospital or clinic pharmacy.
TRICARE Pharmacy Home Delivery is the preferred option for beneficiaries if the military facility pharmacy does not have the drug prescribed. All prescriptions filled through home delivery must have the prescriber’s handwritten signature.
TRICARE retail pharmacy network consists of approximately 60,000 retail pharmacies in the United States and most US territories including Guam, N. Mariana Islands, Puerto Rico and the US Virgin Islands. Non-network retail pharmacies may not accept TRICARE and as the most expensive option, is not recommended for beneficiaries.
Medex BioCare, US Bioservices and Accredo are East Region network specialty pharmacies. Specialty pharmacies are not retail pharmacy providers and much of what they offer is a part of the TRICARE medical benefit, not pharmacy benefit.
Several of the network specialty pharmacies include a “drug list or formulary”. Those pharmacies without a formulary listed expect to be contacted by the provider to determine if a particular drug/item is available to order. Beneficiaries are not allowed to contact one of the specialty pharmacies as it is for physician order only. The process includes a prescription/referral form with a fax number the provider must submit per TRICARE beneficiary, per episode of care.