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Covered Services

Learn more about what we cover -
including health, dental, and pharmacy.

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 prior authorization from your regional contractor before you get your prescription filled. However, you don't need prior authorization before getting home infusion therapy if you:

Getting Home Infusion Therapy

How you get home infusion therapy depends on whether or not you are homeboundTRICARE considers you homebound if you can’t leave your home without a lot of effort..

If 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/copayments will apply.

If Not Homebound, We May Cover Home Infusion Therapy if:

You need it long-term
  • More than 5 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
  • 5 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.

Last Updated 9/4/2018

contact Your Contacts

Express Scripts, Inc.

Stateside: 1-877-363-1303
Overseas: 1-866-275-4732
(where toll-free service is established)

Express Scripts Website

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