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TRICARE Pharmacy Benefit: It's Your Choice
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To make filling prescriptions convenient, TRICARE allows you to choose what works best for you. Your pharmacy choices are:
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Military treatment facility (MTF) pharmacy
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TRICARE Mail Order Pharmacy
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TRICARE retail network pharmacy
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Non-network retail pharmacy
If you seek most of your care at an MTF, filling your prescriptions at an MTF pharmacy may be the best and least expensive option. You can get up to a 90-day supply of most medications free of charge.
Next to using an MTF pharmacy, the TRICARE Mail Order Pharmacy offers the lowest out-of-pocket costs. If you regularly take medications for long-term conditions like asthma, hypertension or diabetes, the mail-order option allows you to receive up to a 90-day supply of your everyday prescriptions for the same price as a one-month supply filled at your local pharmacy. And your medications are delivered directly to your door.
Another option available is the TRICARE retail pharmacy network, although it is more expensive. Choose any one of the more than 54,000 civilian retail network pharmacies throughout the United States and its territories and submit your prescription along with a valid uniformed services card to have your medication filled.
You may consider switching your retail prescriptions to the lower-cost mail-order pharmacy by taking advantage of the Member Choice Center (MCC). Convert your prescriptions today by calling the MCC at 1-877-363-1433. You’ll reduce your pharmacy costs and benefit from the convenience of home delivery.
Using a non-network retail pharmacy is your most expensive option. You may be required to pay the full amount of your prescription up front and then file a claim for reimbursement.
The table below summarizes your TRICARE pharmacy costs, which are determined by prescription type as well as where you choose to have your prescriptions filled.
Remember, Department of Defense policy mandates that TRICARE providers prescribe generic drugs, rather than brand names, whenever a generic equivalent exists.
With generics, you pay a lower cost-share. For a brand-name drug to be dispensed in place of its generic equivalent, a provider must prove medical necessity and obtain prior authorization before writing the prescription. If a generic does not exist, you may receive the brand-name drug at the brand-name copayment.
For more information on filling prescriptions with TRICARE, visit the prescription area on the “My Benefit” link of TRICARE's Web site.
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| Type of Pharmacy |
Formulary Drugs
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Non-Formulary Drugs |
| Generic |
Brand Name |
MTF
(up to a 90-day supply) |
$0 |
$0 |
Not applicable |
Mail Order
(up to a 90-day supply) |
$3 |
$9 |
$22 unless medical necessity is established |
Retail Network
(up to a 30-day supply) |
$3 |
$9 |
$22 unless medical necessity is established |
Non-Network
(up to a 90-day supply) |
$9 or 20% of the total cost, whichever is greater, after your annual outpatient deductible is met. |
$22 or 20%, whichever is greater, after your annual outpatient deductible is met. |
An Important Note about TRICARE Program Information: At the time of printing, this information is current. It is important to remember that TRICARE policies and benefits are governed by public law. Changes to TRICARE programs are continually made as public law is amended.
Military treatment facility guidelines and policies may be different than those outlined in this product. For the most recent information, contact Humana Military, a TRICARE Service Center, or your local military treatment facility.
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