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Your TRICARE plan, which group you’re in (Group A or Group B), and the pharmacy type you use determine whether you may have to meet your annual deductible before copayments or cost-shares apply.
At non-network pharmacies, you’ll have to pay full price for covered drugs up front and file a claim for reimbursement.
You pay the full cost of non-covered drugs.
Are you anactive duty family members with TRICARE Prime Remote in the U.S.?
As of Feb. 28, you have no costs for covered drugs at military pharmacies, home delivery, and retail network pharmacies.
Note: Copayments don't change for survivors of active duty service members and medically retired service members and their family members.
Pharmacy Type
Generic Formulary Drug Costs
Brand-Name Formulary Drug Costs
Non-Formulary Drug Costs
Non-Covered Drug Costs
Military Pharmacy
Up to a 90-day supply
$0
$0
Generally not available without medical necessity
Not available
TRICARE Pharmacy Home Delivery
Up to a 90-day supply
$13
$38
$76
Not available
TRICARE Retail Network Pharmacy
Up to a 30-day supply
$16
$43
$76
Full cost of drug
Non-Network Retail Pharmacy
In the U.S. and U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands)
TRICARE Prime options: 50% cost-share applies after you meet your point-of-service annual deductible
All other beneficiaries: You pay for formulary drugs ($43 or 20% of total cost, whichever is more, after you meet your annual deductible) and non-formulary drugs ($76 or 20% of total cost, whichever is more, after you meet your annual deductible).
Full cost of drug
Non-Network Retail Pharmacy
Outside the U.S. and U.S. territories
ADSMs and ADFMs using TRICARE Prime Overseas or TRICARE Prime Remote Overseas: $0 (You may have to pay the full cost up front and file a claim for reimbursement.)
ADFMs using TRICARE Select Overseas and TRS members: 20% cost-share after you meet your annual deductible
Retirees, their family members, TRR members, and all others in TRICARE Select Overseas: 25% cost-share after you meet your annual deductible
Full cost of drug
Pharmacy Type
Generic Formulary Drug Costs
Brand-Name Formulary Drug Costs
Non-Formulary Drug Costs
Military pharmacy
Up to a 90-day supply
$0
$0
Generally not available without medical necessity
TRICARE Pharmacy Home Delivery
Up to a 90-day supply
$14
$44
$85
TRICARE retail network pharmacy
Up to a 30-day supply
$16
$48
$85
Non-network retail pharmacy
In the U.S. and U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands)
TRICARE Prime enrollees (including US Family Health Plan and TRICARE Prime Demo): A 50% cost-share applies after you meet your point-of-service annual deductible.
All other beneficiaries: After you meet your annual deductible, you pay for formulary drugs ($48 or 20% of total cost, whichever is more) and non-formulary drugs ($85 or 20% of total cost, whichever is more).
Overseas retail pharmacy
Outside the U.S. and U.S. territories
Active duty service members and active duty family members using TRICARE Prime Overseas or TRICARE Prime Remote Overseas: $0 (You may have to pay the full cost up front and file a claim for reimbursement.)
Active duty family members using TRICARE Select Overseas and TRICARE Reserve Select enrollees: A 20% cost-share applies after you meet your annual deductible.
Retirees, their family members, TRICARE Retired Reserve enrollees, and all others in TRICARE Select Overseas: A 25% cost-share applies after you meet your annual deductible.
Section 702 of the NDAA for FY 2018 froze pharmacy copayments at the 2017 rates for:
Medically retired service members and their family members
Survivors of active duty service members
Pharmacy Type
Generic Formulary Drug Costs
Brand-Name Formulary Drug Costs
Non-Formulary Drug Costs
Military pharmacy
Up to a 90-day supply
$0
$0
Generally not available without medical necessity
TRICARE Pharmacy Home Delivery
Up to a 90-day supply
$0
$20
$49
TRICARE retail network pharmacy
Up to a 30-day supply
$10
$24
$50
Non-network retail pharmacy
In the U.S. and U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands)
TRICARE Prime enrollees (including US Family Health Plan and TRICARE Prime Demo): A 50% cost-share applies after you meet your point-of-service annual deductible. (This deductible is $300 per individual or $600 per family.)
TRICARE Select enrollees: You pay $24 or 20% of total cost (whichever is more) after you meet your annual deductible.
Overseas retail pharmacy
Outside the U.S. and U.S. territories
TRICARE Select Overseas enrollees: A 25% cost-share applies after you meet your annual deductible.