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:
- live overseas
- use TRICARE For Life
- have other health insuranceClick to closeHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "other health insurance."
Getting Home Infusion Therapy
How you get home infusion therapy depends on whether or not you are homeboundClick to closeTRICARE 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 therapy from an authorized home health agency||
If Not Homebound, We May Cover Home Infusion Therapy if:
|You need it long-term||
|You need it short-term||
This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryClick to closeTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.
Last Updated 5/29/2019