Save Money at the Pharmacy: Understanding TRICARE Prescription Drug Types

1/16/2019

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 drugsClick to closeA 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

Non-formulary drugs

  • May be less available
  • Highest out-of-pocket costs

Non-covered drugs

  • 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.

Express Scripts, the TRICARE Pharmacy Program contractor, can help you with your pharmacy needs. Visit the Express Scripts website to:

  • 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.
To learn more about your pharmacy benefit, visit the TRICARE Pharmacy. Or download the TRICARE Pharmacy Program Handbook and TRICARE Pharmacy Program Overview there. To view your pharmacy costs, visit Costs on the TRICARE website.

Last Updated 4/26/2019