The TRICARE Pharmacy Program offers comprehensive prescription drug coverage for eligible TRICARE beneficiaries. The TRICARE Pharmacy Program is administered by Express Scripts. In order for a beneficiary to fill a prescription, a written or electronic prescription order is necessary.
Effective October 1, 2015 all TRICARE beneficiaries with the exception of Active Duty Service Members, must obtain select “brand name maintenance drugs” through either their military pharmacy or through the TRICARE Pharmacy Home Delivery Program.
TRICARE beneficiaries have the following options for filling prescriptions:
- Military hospitals and clinics on bases/posts generally have their own pharmacy and offer the least expensive option for TRICARE and the beneficiary (no copay or cost share) to fill prescriptions. However, many formularies vary. The beneficiary can verify availability. E-prescribe is an electronic prescribing capability for civilian providers to send prescription orders directly to a military hospital or clinic pharmacy. For more information please visit the electronic prescribing website.
- TRICARE pharmacy home delivery is the preferred option for beneficiaries if the military hospital or clinic pharmacy does not have the particular drug prescribed available. All prescriptions filled through home delivery must have the prescriber’s handwritten signature. Member Choice Centers help TRICARE beneficiaries to transfer their current military pharmacy or retail pharmacy maintenance medication prescriptions to home delivery.
- TRICARE retail pharmacy network consists of approximately 60,000 retail pharmacies in the United States and most U.S. territories including-(Guam, N. Mariana Islands, Puerto Rico, and the U.S. Virgin Islands)
- Non-network retail pharmacies may not accept TRICARE and as the most expensive option, is not recommended for beneficiaries.
Generic Drug Policy is a TRICARE policy to promote use of generic medications instead of brand-name medications whenever possible.
Prior authorization may be required from Express Scripts for some medications. Medications requiring prior authorization may include prescription drugs specified by the TRICARE Pharmacy Program, brand-name medications with a generic equivalent, medications with age limits, and medications prescribed for quantities exceeding normal limits.
Please direct beneficiaries to call Express Scripts at 1-877-363-1303 for questions concerning Home Delivery and the Member Choice support.
For more information about the TRICARE Pharmacy Program please visit TRICARE.mil/pharmacy or express-scripts.com/TRICARE.