Home Infusion Therapy

TRICARE covers home infusion therapy. Home infusion therapy means taking medicine in your home in a way other than swallowing it. This could be:

• A shot in your muscles
• Given beneath your skin
• Given through your veins
• Infused through a piece of durable medical equipment

You’ll pay pharmacy cost-shares for the infusion drugs. You must have pre-authorization from your regional contractor before you get your prescription filled. However, you don’t need pre-authorization before getting home infusion therapy if you:

• Live overseas
• Use TRICARE For Life
• Have other health insurance

Getting Home Infusion Therapy

How you get home infusion therapy depends on whether or not you’re homebound .

If you’re homebound, you may:

Give yourself the therapy or get the therapy from a caregiver.	You must get the infusion drug from an approved TRICARE network pharmacy. Your doctor must certify that self-administration is medically appropriate.
Get therapy from an authorized home health agency.	The medical supplies and skilled nursing services are covered under the medical benefit. Your health plan’s cost-shares and copayments will apply.

If you aren’t homebound, TRICARE may cover home infusion therapy if:

You need it long-term (more than five infusions in a row).	You, a caregiver, or a home health agency can be authorized to give the therapy. You must get the infusion drug from an approved TRICARE network pharmacy.
You need it short-term (five or fewer infusions in a row).	Only authorized from a home health agency You must get the infusion drug from an approved TRICARE network pharmacy.