TRICARE For Life Pharmacy Pilot
Are you using TRICARE For Life?
Do you fill your prescriptions at a TRICARE network pharmacy?
If you said “yes” to both questions, you may have to participate in the new TRICARE For Life Pharmacy Pilot Program.
What is the Pilot?
The Pilot requires you to fill prescriptions for select maintenance drugs through Home Delivery or at a military pharmacy.
|You Must Participate in the Pilot if You:
||You Don't Have to Participate in the Pilot if You:
- Use TRICARE For Life
- Live in the U.S. or a U.S. territory
- Have a prescription for a drug covered by the Pilot
- Are an active duty family member
- Have other prescription coverage
- Have a prescription for a drug not covered by the Pilot
In some scenarios, you may get a waiver from participating in the Pilot.
Drugs Covered by the Pilot
Maintenance drugs are those that you take regularly for a chronic condition (i.e. high blood pressure, high cholesterol). To see if your drugs are covered by the Pilot:
How the Pilot Works
Express Scripts will tell you if you have to participate in the Pilot.
- When you fill a prescription for a drug covered by the Pilot at a network pharmacy, you'll get a letter from Express Scripts. When you get this letter:
- If you fill your prescription a second time at a network pharmacy, you’ll get another letter from Express Scripts about switching to Home Delivery.
- If you fill your prescription a third time at a network pharmacy, you’re responsible to pay 100% of the cost.
So you get these letters, make sure your address is correct in the Defense Enrollment Eligibility Reporting System (DEERS). You can verify your update your DEERS record online or by calling 1-800-538-9552.
Opting Out of the Pilot
After you participate in the TFL Pharmacy Pilot for at least one year, you can opt-out. Please call Express Scripts at 1-877-363-1303 for:
- Information about how to opt-out
- To see if you qualify