TRICARE:  Summary of Beneficiary Costs

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  TRICARE Pharmacy Program Costs
Pharmacy costs are based on whether the prescription is classified as formulary generic (Tier 1), formulary brand name (Tier 2), or non-formulary (Tier 3) and where you choose to have your prescription filled. Note: Your TRICARE program option only matters if you have a prescription filled at a non-network pharmacy.
 
Non-formulary drugs may be filled at the formulary costs if medical necessity is established. Visit TRICARE Pharmacy for more information. You can also use the Formulary Search Tool at TRICARE Formulary Search to find more specific costs for prescription medications. Note: If you are traveling overseas, be aware that TRICARE retail network pharmacies are only available in the United States, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands. If you have prescriptions filled at a host nation pharmacy, you may be required to pay in full and file a claim for reimbursement.
 
The following table summarizes the costs for prescription drugs. 
Type of Pharmacy

Formulary Costs

Non-formulary Costs
(Tier 3)
Generic
(Tier 1)
Brand Name
(Tier 2)
Military
(up to a 90-day supply)
$0 $0 Not available
Mail Order
(up to a 90-day supply)
$3 $9 $22
Network Retail
(up to a 30-day supply)
$3  $9  $22
Non-network Retail
(up to a 30-day supply)
TRICARE Prime/TPRADFM:
POS fees apply

TRICARE Standard/TRICARE Extra:
$9 or 20% of total cost (whichever is greater) after the annual deductible is met
TRICARE Prime/TPRADFM:
POS fees apply

TRICARE Standard/TRICARE Extra:
$22 or 20% of total cost (whichever is greater) after the annual deductible is met
         

       
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Last Reviewed: February 15, 2008