Save Money at the Pharmacy: Understanding TRICARE Prescription Drug Types
The TRICARE Pharmacy Program provides you the same prescription drug coverage with most TRICARE health plans. If you use the US Family Health Plan, you have a separate pharmacy coverage. As always, active duty service members pay nothing out of pocket for their covered prescription drugs.
Prescription drugs fall into four tiers: generic formulary drugs, brand-name formulary drugs, non-formulary drugsA drug in a therapeutic class that isn’t as clinically or cost-effective as other drugs in the same class. You pay a higher cost share for these drugs., and non-covered drugs. These tiers follow industry standards. They depend on the medical effectiveness and cost effectiveness of a drug compared to other similar drugs.
Your costs will vary depending on your drug category.
Generic formulary drugs
- Widely available
- Lowest out-of-pocket costs
Brand-name formulary drugs
- Generally available
- Higher out-of-pocket costs
- May be less available
- Highest out-of-pocket costs
- Excluded from TRICARE coverage
- You pay the full cost of the drug
If your drug falls into the non-covered category, you’ll have to pay the full cost of the drug. Some reasons TRICARE may not cover a drug include its effectiveness, safety, or cost.
- Find nearby pharmacies.
- Register to have your prescription drugs mailed to you.
- Check your prescription drugs on the TRICARE Formulary.
- Get prior authorization for your prescriptions when necessary.
Last Updated 10/14/2021