TRICARE provides prescription drug coverage with most TRICARE health plans. If you use the US Family Health Plan, you have a separate pharmacy coverage.
The TRICARE Formulary is a list of generic and brand-name prescription drugs that we cover. TRICARE covers most prescription drugs approved by the Food and Drug Administration (FDA). Prescription drugs may be covered under the pharmacy benefit or the medical benefit.
We review and update the TRICARE Formulary each quarter. After each review, some drugs may move from one category to another. You’ll get a letter from Express Scripts if you have a prescription for a formulary drug that’s changing to a non-formulary drug.
- View recent formulary changes
- View quantity limits for prescription drugs
- View prior authorization requirements for certain prescriptions
Covered and Non-Covered Drugs
Your costs will vary depending on your drug category. Prescription drugs fall into four categories:
These categories follow industry standards. They depend on the medical effectiveness and cost effectiveness of a drug compared to other similar drugs.
Most of the time, newly-approved prescription drugs are available from network pharmacies and home delivery soon after they are available for sale. Exceptions include prescription drugs that are:
- Not covered by TRICARE
- Covered only by the medical benefit, but not the pharmacy benefit
- Not suitable for dispensing through the network or home delivery
The TRICARE Formulary is updated with newly-approved prescription drugs, as needed.
These are the drugs you get while you’re hospitalized or during an outpatient visit.
To see a list of drugs TRICARE doesn't cover, go here. And then click on the "Tier 4/Not Covered" link under the "Formulary Related Links" section.
Last Updated 9/3/2019