Prior Authorization

Prior authorization is a routine process.  We use it to make sure your prescription drug is:

• Safe
• Effective
• Medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition.
• Cost effective

You may need prior authorization for your prescription if it:

• Is specified by the DoD Pharmacy & Therapeutics Committee
• Is a brand-name prescription drug with a generic substitute
• Has age limits
• Is prescribed for an amount more than the normal limit

Check the TRICARE Formulary to see if you need prior authorization.   

Search the TRICARE Formulary

How to Get Prior Authorization

• Search for your drug on the TRICARE Formulary Search Tool
• Download and print the form for your drug.
• Give the form to your provider to complete and send back to Express Scripts.
  • Instructions are on the form
  • You don’t need to send multiple forms
• Your authorization approval will apply to network pharmacies and home delivery.

Can't Find a Form?

• Send a message to DOD.customer.relations@express-scripts.com
• Express Scripts will contact you