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Home Infusion Therapy

TRICARE covers home infusion therapy. Home infusion therapy means taking medicine in your home in a way other than swallowing it. This could be:

  • A shot in your muscles
  • Given beneath your skin
  • Given through your veins
  • Infused through a piece of durable medical equipment

You'll pay pharmacy cost shares for the infusion drugs. You must have prior authorization from your regional contractor before you get your prescription filled.

Home infusion therapy isn’t covered if you:

  • are overseas
  • are using TRICARE For Life
  • have other health insurance

Getting Home Infusion Therapy

How you get home infusion therapy depends on whether or not you are homebound Beneficiaries are considered homebound if their conditions are so severe that they can't leave their homes without considerable and taxing effort..

If Homebound, You May:

Give youself the therapy 
  • You must get the infusion drug from an approved TRICARE network pharmacy
  • Your doctor must certify that self-administration is medically appropriate. 
Get therapy from a caregiver
Get therapy from an authorized home health agency 
  • The medical supplies and skilled nursing services are covered under the medical benefit.
  • Your health plan's cost shares/copayments will apply.

If Not Homebound, We May Cover Home Infusion Therapy if:

You need it long-term
  • More than 5 infusions in a row
  • You, a caregiver or a home health agency can be authorized to give the therapy.
  • You must get the infusion drug from an approved TRICARE network pharmacy.
You need it short-term
  • 5 or fewer infusions in a row
  • Only authorized from a home health agency.
  • You must get the infusion drug from an approved TRICARE network pharmacy.

Last Updated 1/14/2014