An official website of the United States government
Here's how you know
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

News | April 21, 2022

Pharmacy Benefit Questions? Check Out This Handbook

By TRICARE Communications

Do you want to learn more about your prescription drug coverage? The TRICARE Pharmacy Program Handbook can help you get the most out of your pharmacy benefit. It’s a helpful resource to learn how your pharmacy benefit works and what it covers.
 
“The TRICARE Pharmacy Program Handbook has everything you need to know, from explaining your eligibility to exploring your pharmacy options,” said Robert Agnello, deputy chief of Digital Communications at the Defense Health Agency. “Learning how your pharmacy benefits work can help you get the quality care you need.”
 
Here’s a look at what information you can find in this pharmacy resource.
 
1. Are you eligible to use TRICARE’s pharmacy benefit?
The TRICARE Pharmacy Program is administered by Express Scripts. It’s available to eligible service members, retirees, and family members. As outlined in the handbook, you must be registered in the Defense Enrollment Eligibility Reporting System (DEERS). And it’s important to keep information in DEERS up to date for you and your family members. Failure to keep your information accurate in DEERS could affect your TRICARE eligibility, including your pharmacy benefit.  
 
If you have the US Family Health Plan (USFHP), however, you aren’t eligible for the TRICARE Pharmacy Program. This means you must use USFHP pharmacy providers. For all other TRICARE health plans, including TRICARE For Life, you’re eligible to use TRICARE’s pharmacy benefit. Check out the “Getting Started” section of the handbook to learn more.
 
2. What are your options for filling your prescription?
TRICARE provides you with several pharmacy options. The handbook includes information on these four pharmacy options:  
Which pharmacy option is best for you to fill your prescription? That depends on the type of drug you need and where you live. Keep in mind, some drugs must be filled a certain way. And the quantity limits and out-of-pocket cost of your drug may also vary by the type of pharmacy.
 
3. What types of drugs are covered?
TRICARE doesn’t cover certain drugs for a variety of reasons. Prescription drugs that TRICARE doesn’t cover are included in the non-covered drug category. As for covered drugs, the handbook breaks down three types:  
TRICARE bases this grouping on the medical cost and effectiveness of a drug compared to other drugs of the same type. Did you know the TRICARE Formulary includes a list of prescription drugs that TRICARE covers? TRICARE reviews and updates this list each quarter.
 
As mentioned in the handbook, you can also use TRICARE Formulary Search Tool to learn more about your prescriptions. For example, find if your prescription drug requires pre-authorization. Learn more from the “Covered Services, Limitations, and Exclusions” section of the handbook.
 
There are more parts to the pharmacy benefit to help you manage your prescriptions that this handbook can help you with. Take a moment to also browse other TRICARE resources like the TRICARE Pharmacy Program Overview. Don’t forget to take the Publications Feedback Survey, and share your thoughts on how we can improve our publications.
 
Would you like the latest TRICARE news sent to you by email? Visit the TRICARE Subscriptions page today, and create your personalized profile to get benefit updates, news, and more.
Join our next TRICARE Webinar - Using Your TRICARE Pharmacy Benefits on March 14, 2024 from 1 to 2 p.m. ET.

Learn About TRICARE Pharmacy Benefits at March 1...

News
Feb. 29, 2024

Are you making the most of your prescription drug coverage? Have you heard about changes to the process for...
Read More
A prescription bottle is filled

Change Healthcare Cyberattack Impact on MHS Phar...

News
Feb. 22, 2024

A reported cyberattack on the nation’s largest commercial prescription processor, Change Healthcare, has...
Read More
Close-up image of man's arms and hands, holding a piece of paper and eyeglasses.

Preventing TRICARE Fraud and Abuse Is Everyone’s...

News
Feb. 14, 2024

Fraud and abuse can target your TRICARE medical, pharmacy, and dental coverage. If you think someone is...
Read More
A delivery person hands a package to a woman

Learn About TRICARE Pharmacy Network Changes for...

News
Feb. 06, 2024

The TRICARE Pharmacy Program is improving how we manage specialty drugs. Starting March 1, Accredo will...
Read More
The 6th FSS identification card office was named the highest performing Department of the Air Force team for the 2023 fiscal year. (U.S. Air Force photo by Airman 1st Class Zachary Foster)

Headed To the Doctor? Bring Proof of Your TRICAR...

News
Feb. 01, 2024

Are you preparing for a trip to the doctor’s office or the pharmacy? If so, make sure you have proof of your...
Read More
Airman, his wife, and twin infant daughters

Explore What TRICARE Covers

News
Jan. 25, 2024

TRICARE offers comprehensive coverage to help you get and stay healthy. Knowing what’s included in this...
Read More
A senior couple smiles on a sidewalk.

4 Reminders About Getting Care With TRICARE For ...

News
Jan. 23, 2024

Do you have TRICARE For Life? Knowing how Medicare coverage works can help you avoid unexpected costs. Learn...
Read More
The Brandon Act written over a backround of green circles with patches of stars and stripes and the link text: Health.mil/BrandonAct.

For Service Members, Access to Mental Health Car...

News
Jan. 22, 2024

The Brandon Act has greatly simplified and sped up the process of helping service members get mental health...
Read More

Feb. 29, 2024

Learn About TRICARE Pharmacy Benefits at March 14 Webinar

Are you making the most of your prescription drug coverage? Have you heard about changes to the process for getting specialty drugs? Join us for a webinar, “Using Your TRICARE Pharmacy Benefits,” on Thursday, March 14, from 1 to 2 p.m. ET.

Feb. 22, 2024

Change Healthcare Cyberattack Impact on MHS Pharmacy Operations

A reported cyberattack on the nation’s largest commercial prescription processor, Change Healthcare, has affected military clinics and hospitals nationwide. On Feb. 21, 2024, Change Healthcare disconnected its systems to protect patient information. This is impacting all military pharmacies worldwide and some retail pharmacies nationally.

Feb. 14, 2024

Preventing TRICARE Fraud and Abuse Is Everyone’s Responsibility

Fraud and abuse can target your TRICARE medical, pharmacy, and dental coverage. If you think someone is committing fraud or abuse related to your TRICARE benefits, you should report it.

Feb. 6, 2024

Learn About TRICARE Pharmacy Network Changes for Specialty Drugs

The TRICARE Pharmacy Program is improving how we manage specialty drugs. Starting March 1, Accredo will provide specialty drugs and enhanced clinical services if you fill TRICARE-defined specialty prescriptions with TRICARE Home Delivery. Accredo will also stay in the TRICARE network as an in-network retail pharmacy.  

Feb. 1, 2024

Headed To the Doctor? Bring Proof of Your TRICARE Coverage

Are you preparing for a trip to the doctor’s office or the pharmacy? If so, make sure you have proof of your TRICARE coverage.

Jan. 25, 2024

Explore What TRICARE Covers

TRICARE offers comprehensive coverage to help you get and stay healthy. Knowing what’s included in this coverage can help you make the most of your benefit and avoid unexpected costs.

Jan. 23, 2024

4 Reminders About Getting Care With TRICARE For Life

Do you have TRICARE For Life? Knowing how Medicare coverage works can help you avoid unexpected costs. Learn about getting care with Medicare and TRICARE For Life.

Jan. 22, 2024

For Service Members, Access to Mental Health Care Streamlined Under Brandon Act

The Brandon Act has greatly simplified and sped up the process of helping service members get mental health treatment if they need it.

Jan. 17, 2024

How TRICARE Covers Ambulance Services

In some emergencies, an ambulance could be the difference between life and death. Fortunately, your TRICARE plan covers ambulance services in these situations.

Jan. 11, 2024

Mental Health Is Health: Depression and Oral Health

Depression can cause you to neglect your oral health if you aren’t able to motivate yourself to do daily tasks like brushing your teeth and flossing. See how TRICARE can help your mental and oral health.