Skip to main content
Emergency Procedures in Place for Parts of US
Click here for the latest information on emergency procedures in place.

Covered Services

Learn more about what we cover -
including health, dental, and pharmacy.

Non-Formulary Drugs

Non-formulary drugsA 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 the third tier of the TRICARE Formulary and are covered with a higher cost shareA percentage of the total cost of a covered health care service that you pay. than those classified as "Formulary-Generic" or "Formulary-Brand Name." >>View Pharmacy Costs

  • Some non-formulary drugs are only covered through home delivery.
  • You can get the non-formulary drugs at the formulary cost share (or at no cost for active duty) if your provider can establish medical necessity.  
 

Search the TRICARE Formulary

You'll find a list of alternative drugs and links to the medical necessity criteria and forms.

How to Get Medical Necessity for Non-Formulary Drugs

  • Search for your drug on the TRICARE Formulary Search Tool
  • Download and print the form for your drug.
  • Give the form to your provider to complete and send back to Express Scripts.
    • Instructions are on the form
    • You don’t need to send multiple forms
  • Your medical necessity approval will apply at network pharmacies and home delivery.

Can't Find a Form?

Non-Formulary Prescriptions at Military Pharmacies

You can fill your prescription for a non-formulary drug at a military pharmacy ONLY IF:

  • Written by a provider at that military hospital or clinic, and
  • Medical necessity is established. 

Military pharmacies aren’t required to fill a prescription for a non-formulary drug written by a civilian provider, but MAY do so IF:

  • You were referred to the civilian provider, and
  • Medical necessity is established.

Last Updated 9/4/2018

contact Your Contacts

Express Scripts, Inc.

Stateside: 1-877-363-1303
Overseas: 1-866-275-4732
(where toll-free service is established)

Express Scripts Website


View More Contacts