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 | Feb. 8, 2022

5 Reasons to Check Your Prescription on the TRICARE Formulary Search Tool

By TRICARE Communications

Do you have questions about your prescription drug? Maybe you don’t know where you can fill your new prescription, or how much it will cost. TRICARE and its pharmacy contractor, Express Scripts, provides an online tool where you can search for information on specific drugs to see whether they’re available through the TRICARE pharmacy benefit. It’s called the TRICARE Formulary Search Tool.
 
“The TRICARE Formulary Search Tool is a convenient way to learn about your prescription drugs, so you know your options when managing your medications,” said U.S. Public Health Service Cmdr. Teisha Robertson, a pharmacist with the Defense Health Agency’s Pharmacy Operations Division. “Both you and your doctor can use this pharmacy tool to answer questions about your drug coverage, where you can fill your prescriptions, and any applicable copayments.”
 
Here are five ways the search tool can keep you informed about your prescriptions.
 
1. Formulary status (drug category)
The TRICARE pharmacy benefit covers several types of drugs. If you aren’t sure if TRICARE covers your prescription drug, you can look it up. The type of drug you get will determine how much you pay, as costs may vary depending on the drug’s category. As outlined in the TRICARE Pharmacy Program Overview, TRICARE groups prescription drugs into four categories: Your pharmacy will generally fill your covered prescription with a generic drug. But a provider can prescribe a brand-name drug for you if the provider completes an approval process.
 
2. Where your prescription can be filled and any applicable copayments
The search tool can show you your TRICARE pharmacy options for filling your prescription. And it shows you costs based on your beneficiary category and the type of drug you’re prescribed. Your options may include:  The search tool doesn’t show drug information for non-network pharmacies. If you use a non-network pharmacy, you’ll have to pay full price for your covered prescription drug and file a claim for reimbursement. Reimbursements are subject to annual deductibles, out-of-network cost-shares, and copayments.
 
If you live overseas and fill your prescription at a non-network pharmacy outside the U.S. and U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands), you’ll also have to pay the full price of your prescription at the pharmacy and file a claim for reimbursement. You’ll need to file your claim with the TRICARE Overseas Program claims processor. All deductibles must be met before any reimbursement can be made.
 
If you’re an active duty service member, you have no copayments for covered drugs when you use military pharmacies, home delivery, or retail network pharmacies. For others, refer to the search tool and TRICARE Compare Cost Tool to see how much you’ll pay out of pocket. Keep in mind, you may have to meet your annual deductible before copayments or cost-shares apply for certain pharmacy types.
 
3. Coverage details and limitations
Some drugs require pre-authorization or medical necessity forms to be filled out by your doctor before your prescription can be filled. You can find these forms with your prescription drug’s information in the search tool. TRICARE requires pre-authorization for some drugs to make sure they’re safe, effective, medically necessary, and cost-effective. Also, there are times when a doctor may say a non-formulary drug is a medical necessity. If your non-formulary drug meets certain criteria, you can get it at the lower formulary cost.
 
You can learn more about coverage rules and requirements in the TRICARE Pharmacy Program Handbook.  
 
4. Drug information
Want to know more about the drug you’re taking? The search tool shows you side effects, quantity limits, or restrictions that may apply to your drug. You can also click on the “About this drug” link for alternate drug names and frequently asked questions.
 
5. Other drug options
If TRICARE doesn’t cover your prescribed drug, you or your doctor can see if there’s an alternative drug that’s covered. You can also check the search tool to see if there are generic equivalents.

The TRICARE Formulary Search Tool is easy to use, so get started learning about your prescriptions today. And visit the TRICARE website to learn more about your pharmacy benefit. If you have questions, you can contact Express Scripts.
Military Pharmacy technician smiles at patient

Military Pharmacies Restored to Full Operations ...

News
Apr. 11, 2024

Military pharmacies have returned to normal operations following a February cyberattack on the nation's...
Read More
Female Uniformed Service Member looks at mammogram images on a monitor with a keyboard.

The Power of Prevention: Get Cancer Screenings W...

News
Apr. 09, 2024

Catching cancer early is one of the best ways to protect yourself and your loved ones from cancer. Routine...
Read More
Heart Health: BAMC incorporates lifestyle medicine into cardiac rehab program

Look After Your Heart With Help From TRICARE

News
Apr. 04, 2024

Keeping your heart healthy is important at every age. Catching heart disease early gives you the best chance...
Read More
Screenshots of the latest issue of the TRICARE Health Matters Dental Newsletter. Callout box with text says, "Catch up on the latest dental news! www.tricare.mil/newsletters"

Check Out the Latest TRICARE Dental Program News...

News
Apr. 02, 2024

The latest issue of the TRICARE Health Matters Dental Newsletter is now online. It's full of information about...
Read More
Woman in wheelchair looks at her daughter's phone

Q&A: How TRICARE Covers Durable Medical Equipment

News
Mar. 28, 2024

TRICARE covers a range of DME, so you and your family can make the most of this equipment if you need it.
Read More
Provider wearing white lab coat flips through papers with charts on clipboard.

The HIPAA Privacy Rule and Military Health Care:...

News
Mar. 21, 2024

Are you the parent or legal sponsor of a minor child? If so, there are things you should know about what...
Read More
Collage image that displays the cover of the TRICARE Choices in the United States Handbook in front of other TRICARE handbooks.

Get To Know Your TRICARE Options in the U.S.

News
Mar. 20, 2024

Are you new to TRICARE and wondering what your health, dental, and vision coverage options are? If you live in...
Read More
Infographic including stick figure typing on laptop and a speech bubble with prescription bottle. Text reads "Military Health System MHS GENESIS - Refills are here!"

New Feature of MHS GENESIS Patient Portal Allows...

News
Mar. 15, 2024

The Defense Health Agency has launched a new feature that lets you request prescription refills through MHS...
Read More

April 11, 2024

Military Pharmacies Restored to Full Operations After Change Healthcare Cyberattack

Military pharmacies have returned to normal operations following a February cyberattack on the nation's largest commercial prescription processor, Change Healthcare.

April 9, 2024

The Power of Prevention: Get Cancer Screenings With TRICARE

Catching cancer early is one of the best ways to protect yourself and your loved ones from cancer. Routine cancer screening tests can find many common cancers before they cause symptoms.

April 4, 2024

Look After Your Heart With Help From TRICARE

Keeping your heart healthy is important at every age. Catching heart disease early gives you the best chance for treatment to work well—and TRICARE makes it easy to get the preventive care you need.

April 2, 2024

Check Out the Latest TRICARE Dental Program Newsletter

The latest issue of the TRICARE Health Matters Dental Newsletter is now online. It's full of information about the TRICARE Dental Program and oral health.

March 28, 2024

Q&A: How TRICARE Covers Durable Medical Equipment

TRICARE covers a range of DME, so you and your family can make the most of this equipment if you need it.

March 21, 2024

The HIPAA Privacy Rule and Military Health Care: What Parents of Minors Need To Know

Are you the parent or legal sponsor of a minor child? If so, there are things you should know about what access you have to your child’s health care records and choices. The Health Insurance Portability and Accountability Act Privacy Final Rule protects minors’ privacy concerning their health care choices and treatment.

March 20, 2024

Get To Know Your TRICARE Options in the U.S.

Are you new to TRICARE and wondering what your health, dental, and vision coverage options are? If you live in the United States, the TRICARE Choices in the United States Handbook is a great place to start.

March 15, 2024

New Feature of MHS GENESIS Patient Portal Allows Prescription Refills

The Defense Health Agency has launched a new feature that lets you request prescription refills through MHS GENESIS.

March 12, 2024

Maintaining Your Military Health Records Overseas

No matter where you live, it’s important for your electronic health record to be complete and up to date. For TRICARE Prime Overseas and TRICARE Prime Remote Overseas beneficiaries, there are processes that help make this possible.

March 11, 2024

DOD Amends Assisted Reproductive Services Policy for Severely Ill and Injured Active Duty Service Members

DOD amended its policy covering assisted reproductive technology services to expand access for severely ill and injured active duty service members.