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Provider Handbook
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TRICARE Pharmacy Program
Generic Drug Use Policy |
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TRICARE Pharmacy Program |
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TRICARE provides a world-class pharmacy benefit. TRICARE beneficiaries are eligible for the TRICARE Pharmacy Program, including Medicare-eligible beneficiaries age 65 and over. Medicare-eligible beneficiaries, with the exception of ADSMs, Uniformed Services Family Health Plan enrollees, and beneficiaries who turned 65 years of age prior to April 1, 2001, must enroll in Medicare Part B and ensure their DEERS profile is updated to use the TRICARE Pharmacy benefit.
Eligible beneficiaries can use any of these options to have a written prescription filled:
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- MTF pharmacies
- TRICARE Mail Order Pharmacy
- 1-866-DoD-TMOP (1-866-363-8667) inside the U.S.
- 1-866-ASK-4PEC (1-866-275-4732) outside the U.S.
- TRICARE Retail Pharmacy (TRRx) network
- 1-866-DoD-TRRX (1-866-363-8779)
- Non-network pharmacies*
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* Filling prescriptions in non-network pharmacies is the most expensive option and is not recommended to beneficiaries. |
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To have a prescription filled, beneficiaries will need a written prescription and a valid uniformed services ID card. |
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Generic Drug Use Policy |
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It is a mandatory Department of Defense (DoD) policy to use generic medications instead of brand-name medications, when available. If a generic equivalent drug does not exist, the brand-name drug will be dispensed at the brand-name cost. For more information on non-formulary medications, you may direct beneficiaries to the TRICARE Formulary Search Tool. |
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Medical Necessity for Brand-Name Medications |
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Brand-name drugs that have a generic equivalent may be dispensed only if the prescribing physician is able to justify medical necessity for use of the brand-name drug in place of the generic equivalent. If you feel that a brand-name medication (for which a generic equivalent is available) is medically necessary, you should receive prior authorization before writing the prescription. Otherwise, the beneficiary may be responsible for the entire cost of the medication. |
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