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 covered with a higher cost share than drugs in the generic formulary or brand-name formulary categories >>View Pharmacy Costs
- Some non-formulary drugs are only covered through home delivery.
- If your provider can establish medical necessity, you can get the non-formulary drugs at the formulary cost share (or at no cost for active duty).
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?
- Send a message to DOD.firstname.lastname@example.org
- Express Scripts will contact you
Last Updated 4/20/2022