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Get Medical Necessity for Non-Formulary Drugs

You can get the non-formulary drug at a retail network pharmacy or home delivery for the lower "formulary" cost share (or at no cost for active duty) if you can establish medical necessity:

  • 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.

If you can't find the form you need, send a message to DOD.customer.relations@express-scripts.com with your information and Express Scripts will contact you.

You can search the TRICARE Formulary to learn more about specific drugs, copayments, and common drug interactions, or to check for generic equivalents or determine if a drug is considered a non-formulary medication.

Search the TRICARE Formulary

Last Updated 1/21/2016

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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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