What is TRICARE?
TRICARE is the health care program for uniformed service members, retirees, and their families around the world. As part of this comprehensive coverage, the TRICARE Pharmacy Program provides prescription drug benefits that help beneficiaries manage their health through affordable medications.
Understanding the TRICARE Pharmacy Program
The TRICARE Pharmacy Program offers convenient and affordable options for filling prescriptions. Whether you're on active duty, a family member, or a retiree, understanding how to maximize these benefits can help you maintain your health while managing costs effectively.
Program Goals
- Provide convenient access to prescription medications
- Ensure medications are clinically appropriate and cost-effective
- Maintain quality of care while managing costs
- Support the health and wellness of all TRICARE beneficiaries
Pharmacy Coverage Options
TRICARE offers three primary options for obtaining prescription medications, each with different costs and convenience factors:
1. Military Pharmacy (Most Cost-Effective)
Military pharmacies are located at military treatment facilities and provide prescriptions at no cost to beneficiaries. These pharmacies stock a wide selection of commonly prescribed medications but may have limited quantities or specific formulary restrictions.
2. TRICARE Pharmacy Home Delivery
Home delivery offers a convenient option for maintenance medications. Express Scripts serves as the TRICARE pharmacy contractor. Prescriptions can be ordered online, by phone, or by mail and are delivered directly to your home.
3. Network Pharmacies
The retail pharmacy network includes major chains and independent pharmacies across the country and overseas. These locations provide convenient access for immediate medication needs or when other options aren't available.
Cost Comparison
| Pharmacy Option | Generic Medications | Brand-Name Formulary Medications | Non-Formulary Medications |
|---|---|---|---|
| Military Pharmacy | $0 | $0 | $0 (if available) |
| Home Delivery (90-day supply) | $13 | $42 | $79 |
| Retail Pharmacy (30-day supply) | $14 | $53 | $100 |
*These costs may vary based on your specific TRICARE plan and beneficiary category.
Eligibility Requirements
Most people eligible for TRICARE health care are also eligible for the TRICARE Pharmacy Program. This includes:
- Active duty service members
- Active duty family members
- National Guard and Reserve members and their families
- Retirees and their family members
- Survivors of deceased service members
- Certain former spouses
- Recipients of the Medal of Honor and their families
- Other registered beneficiaries in specific categories
How to Use Your TRICARE Pharmacy Benefit
Getting Started
- Verify your eligibility and update your information in the Defense Enrollment Eligibility Reporting System (DEERS)
- Register for a secure account on the TRICARE website or mobile app
- Obtain your prescription from a military or civilian provider
- Choose your preferred pharmacy option to fill your prescription
Transferring Prescriptions
You can transfer prescriptions between retail pharmacies or from a retail pharmacy to home delivery. Simply provide the new pharmacy with your prescription information and your TRICARE beneficiary information. Prescriptions from military pharmacies cannot be transferred to retail pharmacies or home delivery.
TRICARE Formulary System
The TRICARE formulary is a list of prescription medications that are covered. Medications are categorized as:
- Formulary: Drugs on the preferred list, usually available at lower cost
- Non-formulary: Drugs not on the preferred list, typically available at higher cost
- Excluded: Drugs not covered by TRICARE except in limited circumstances
Special Pharmacy Programs
TRICARE For Life (TFL)
For Medicare-eligible beneficiaries, TRICARE For Life provides pharmacy coverage secondary to Medicare Part D. You still have access to military pharmacies and home delivery, with costs similar to other TRICARE plans.
Maintenance Medications
Many health plans now require maintenance medications to be filled through home delivery or military pharmacies. Maintenance medications are those taken regularly for ongoing conditions like high blood pressure, diabetes, or heart disease. This requirement helps reduce costs while ensuring convenient access to necessary medications.
Specialty Medications
Some medications require special handling, administration, or monitoring. These specialty medications, often used for complex or chronic conditions like cancer, rheumatoid arthritis, or multiple sclerosis, are typically available through the specialty pharmacy service within the home delivery program to ensure proper delivery and patient support.
Managing Your Pharmacy Benefit
Online Tools
- Register for a TRICARE online account to manage prescriptions
- Set up automatic refills for home delivery prescriptions
- Check drug costs and formulary status
- Find network pharmacies near you
- View your medication history
Cost-Saving Tips
- Use generic medications when available
- Choose formulary medications over non-formulary options
- Fill maintenance medications through home delivery
- Check military pharmacy availability before using retail options
- Consider 90-day supplies when appropriate
- Ask your provider about therapeutic alternatives if your medication is costly
Overseas Pharmacy Options
TRICARE beneficiaries stationed or living overseas have pharmacy options tailored to their location:
- Military pharmacies at overseas installations: Available at no cost
- Host nation pharmacies: May be covered under specific TRICARE Overseas Program provisions
- Home delivery: Available with shipping to APO, FPO, and DPO addresses
Contacting TRICARE Pharmacy
For questions about the TRICARE Pharmacy Program, you can:
- Visit the official TRICARE website at tricare.mil
- Call the Express Scripts customer service line (1-877-363-1303)
- Use the secure messaging feature on the TRICARE website
- Contact your local TRICARE Service Center
Conclusion
The TRICARE Pharmacy Program provides comprehensive prescription drug coverage designed to keep military families healthy while managing healthcare costs effectively. By understanding the available options and how to maximize your benefits, you can ensure access to the medications you need at the lowest possible cost.
