Prior authorization is a routine process. We use it to make sure your prescription drug is:
- Medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition.
- Cost effective
You may need prior 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 prior authorization.
How to Get Prior Authorization
- 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 authorization approval will apply to network pharmacies and home delivery.
Can't Find a Form?
- Send a message to DOD.email@example.com
- Express Scripts will contact you
Last Updated 5/7/2019