Changes

There are many changes to the TRICARE program every year. Sign up for email alerts.

 
Change

Overview

Continuous glucose monitoring system (CGMS) devices

 

Starting Jan. 1, 2020, TRICARE expands coverage of continuous glucose monitoring system (CGMS) devices. You may be eligible for a CGMS device if you meet certain criteria. TRICARE will only cover CGMS devices approved by the Food and Drug Administration (FDA).

You can submit your claim form to your regional contractor after Feb. 24, 2020.

You may be reimbursed for a CGMS device if:

  • You purchased your CGMS device on or after Jan. 1, 2020.
  • You kept your receipt.
  • CGMS device is FDA approved.
3D Mammography Coverage

On Jan. 1, 2020, TRICARE expands coverage for breast cancer screenings to include digital breast tomosynthesis, or 3-D mammography. 3-D mammography is currently covered for diagnostic purposes. TRICARE will cover 3-D mammography as a preventive health care service through the provisional coverage program.

For more information about mammograms in general, visit the mammography page. 

 

2020 Pharmacy CopaymentClick to closeA fixed dollar amount you may pay for a covered health care service or drug. Changes

Starting Jan. 1, 2020, TRICARE pharmacy copayments will change for all beneficiaries, except Active Duty Service Members (ADSMs), dependent survivors of ADSMs, and medically retired service members and their dependents. 

The new copayments depend on where you fill your prescriptions:

  • Military Pharmacy
    • You can still ­fill your generic and brand-name prescriptions for $0 copayment at military pharmacies.
    • Non-formulary drugsClick to closeA drug in a therapeutic class that isn’t as clinically or cost-effective as other drugs in the same class. You pay a higher cost share for these drugs. are generally not available without medical necessity. 
  • TRICARE Pharmacy Home Delivery (up to a 90-day supply)
    • Generic formulary drugs will change from $7 to $10.
    • Brand-name formulary drugs will change from $24 to $29.
    • Non-formulary drugs will change from $53 to $60.
  • Network Retail Pharmacy (up to a 30-day supply)
    • Generic formulary drugs will change from $11 to $13.
    • Brand-name formulary drugs will change from $28 to $33
    • Non-formulary drugs will change from $53 to $60.
  • Non-Network Retail Pharmacy (up to a 30-day supply)
    • TRICARE Prime enrollees (including US Family Health Plan and TRICARE Young Adult - Prime): Still 50% cost-shareClick to closeA percentage of the total cost of a covered health care service that you pay. after meeting the point-of-service deductible.
    • All Other Plans:
      • Generic formulary drugs & brand-name formulary drugs: $33 (change from $28) or 20% of total cost, whichever is more, after meeting the annual deductible.
      • Non-formulary drugs: $60 (change from $53) or 20% of total cost, whichever is more, after meeting the annual deductible. 

Last Updated 2/21/2020