Improved TRICARE Formulary Search Tool Helps You Learn About Your Prescriptions
Do you have questions about your prescriptions or medications? The TRICARE Formulary Search Tool is an educational tool that can help.
“Our online search tool has been refreshed and is now even easier to navigate,” said Lt. Col. Melissa Pammer, deputy chief of the Purchased Care Branch, Pharmacy Operations Division at the Defense Health Agency. “The search tool can give you information about your medication, let you know whether it’s covered under the TRICARE pharmacy benefit, provide any required forms that your provider needs to complete, and show you what you can expect to pay at each pharmacy type.”
The TRICARE Pharmacy Program provides prescription drug coverage for all TRICARE beneficiaries. Those prescriptions are managed through the pharmacy contractor, Express Scripts. You find the TRICARE Formulary Search Tool on the Express Scripts website.
To start your search, you’ll need to put in the brand name or generic name of the drug and then select the strength prescribed, as well as your gender and age. The updated tool makes it easier to look up specific information about your prescription drug. A search can tell you:
- Formulary status (generic drug, brand-name drug, non-formulary drug, non-covered drug)
- Where the prescription can be filled (details below)
- Copayments and limitations, such as prior authorization
- Coverage review requirements and forms
- Alternative medications, including costs
“Using the TRICARE Formulary Search Tool and learning the best ways to fill your prescription is an important part of taking command of your health,” said Pammer.
The TRICARE Formulary Search Tool can help you determine where to fill your prescription. As outlined in the TRICARE Pharmacy Program Overview, how you fill your prescription depends on your beneficiary category and the type of drug you’re prescribed. Here are your choices when it comes to having your prescriptions filled:
- Military pharmacies. If you want to keep your costs low, fill your prescriptions for free at a military pharmacy. You can get up to a 90-day supply of most covered generic and brand-name drugs at no charge. Military pharmacies usually don’t carry non-formulary drugs.
- TRICARE Pharmacy Home Delivery. This is a convenient way to get your prescriptions. With home delivery, you can get up to a 90-day supply of most drugs. Some limits to home delivery include:
- Controlled substances (based on the laws where the prescription is being delivered)
- If you have other health insurance
- Mailing overseas must be to an APO/FPO address, isn’t available for refrigerated medications, and isn’t available in Germany
- TRICARE retail network pharmacies. If you need a prescription filled, you can also visit a network pharmacy. You have to pay a CopaymentA fixed dollar amount you may pay for a covered health care service or drug. for each 30-day supply of a covered drug. You can search online to find a network pharmacy near you. You can also call Express Scripts at 1-877-363-1303.
- Non-network pharmacies. If you need to fill a prescription at a non-network pharmacy in the U.S. or certain U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands), you’ll pay full price for your prescription drugs and file a claim for partial reimbursement, after you meet your deductible. Overseas pharmacies are non-network. You’ll have to pay the full cost up front and file a claim for partial reimbursement, after you meet your deductible.
Take command of your health and your prescriptions with TRICARE. If you have questions about using the TRICARE Formulary Search Tool, contact Express Scripts. You can also learn more about your pharmacy benefits by going to Pharmacy on the TRICARE website.
Last Updated 9/22/2020