Non-Formulary Drugs

Do you have a prescription for a drug that is non-formularyAny drug in a therapeutic class determined to not be as clinically-effective or as cost-effective as other drugs in the same class.?

  • You can find a list of alternative drugs by searching TRICARE's Formulary.
  • You'll also find links to the medical necessity criteria and forms.

Search the TRICARE Formulary Button

  • You can get non-formulary drugs filled for a higher cost through home delivery and at most retail network pharmacies.
  • 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. >>View Prescription Costs

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 4/30/2015

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

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