TRICARE provides prescription drug coverage with most TRICARE health plans. If you use the US Family Health Plan, you have a separate pharmacy coverage.
The TRICARE Formulary is a list of generic and brand-name prescription drugs that we cover. TRICARE covers most prescription drugs approved by the Food and Drug Administration (FDA). Prescription drugs may be covered under the pharmacy benefit or the medical benefit.
We review and update the TRICARE Formulary each quarter. After each review, some drugs may move from one category to another. You’ll get a letter from Express Scripts if you have a prescription for a formulary drug that’s changing to a non-formulary drug.
Covered and Non-Covered Drugs
Your costs will vary depending on your drug category. Prescription drugs fall into four categories:
These categories follow industry standards. They depend on the medical effectiveness and cost effectiveness of a drug compared to other similar drugs.
Certain prescriptions require a pre-authorization. You may need pre-authorization for your prescription if it:
- Is specified by the DoD Pharmacy & Therapeutics Committee
- Is a brand-name prescription drug with a generic substitute
- Has age limits
- Is prescribed for an amount more than the normal limit
Check the TRICARE Formulary to see if you need pre-authorization.
There are specific rules for filling prescriptions for certain types of drugs. Learn more about filling prescriptions for these drugs:
Quantity limits vary by type of pharmacy:
- Military Pharmacy: up to a 90-day supply
- Home Delivery: up to a 90-day supply
- Network Pharmacy: up to a 30-day supply
Exceptions can be made if your provider establishes medical necessity.
Last Updated 5/1/2023