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What are my pharmacy benefits?
The TRICARE For Life (TFL) pharmacy benefit is administered by Express Scripts, Inc. (Express Scripts). All pharmacy/prescription related inquiries, questions and concerns should be directed to Express Scripts.
Online: Visit www.express-scripts.com/TRICARE.
Phone: Call (877)363-1303 (Express Scripts Member Choice Center) or (877)540-6261 (TDD/TTY).
Express Scripts offers comprehensive prescription drug coverage and several options for filling your prescriptions. To fill a prescription, you need a prescription and a valid Uniformed Services Identification (ID) card or Common Access Card.
When traveling overseas, be prepared to pay up front for medications and file a claim for reimbursement for non-military hospital or clinic and non-network pharmacy services. TRICARE For Life (TFL) recommends that you fill all of your prescriptions before traveling overseas.
Note: You do not need a Medicare Part D prescription drug plan to keep your TRICARE prescription drug coverage.
Military pharmacies are usually located within military hospitals and clinics and are the least expensive option for filling prescriptions. At a military pharmacy, you may receive up to a 90-day supply of most medications at no cost. Most military pharmacies accept prescriptions written by both civilian and military providers, regardless of whether or not you are enrolled at the military hospital or clinic.
Non-formulary medications are generally not available at military pharmacies. To check the availability of a particular drug, contact the nearest military pharmacy.
TRICARE Pharmacy Home Delivery
TRICARE Pharmacy Home Delivery is your least expensive option when not using a military pharmacy. Receive up to a 90-day supply of generic formulary medications at low cost, however copayments apply for brand-name and non-formulary medications (up to a 90-day supply). Additionally, prescriptions are delivered to you with free standard shipping, and refills can be easily ordered online, by phone, or by mail. Home delivery also provides you with convenient notifications about your order status, refill reminders, and assistance in renewing expired prescriptions.
For faster processing of your mail-order prescriptions, register before placing your first order at www.express-scripts.com/TRICARE. Once you are registered, your provider can send prescriptions electronically or by phone. Express Scripts sends your medications directly to your home within about 14 days of receiving your prescription.
If you have prescription drug coverage through Other Health Insurance (OHI), you can use TRICARE Pharmacy Home Delivery only if the medication is not covered under your OHI or if you exceed the OHI’s coverage limit.
TRICARE Retail Network Pharmacies
Another option for filling your prescriptions is through TRICARE retail network pharmacies. To fill prescriptions (one copayment per 30-day supply) present your written prescription and uniformed services ID card to the pharmacist. This option allows you to fill your prescriptions at TRICARE retail network pharmacies throughout the country without having to submit a claim. You have access to approximately 57,000 retail network pharmacies in the United States and the U.S. territories of Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.
Visit www.express-scripts.com/TRICARE or call 1-877-363-1303 for customer service, including finding the nearest TRICARE retail network pharmacy.
When visiting non-network pharmacies, you pay the full price of your medication up front and file a claim to Express Scripts for reimbursement. Reimbursements are subject to deductibles, out-of-network cost-shares, and TRICARE-required copayments. All deductibles must be met before any reimbursement can be made.
For more information about pharmacy costs, see the Pharmacy Calculator tool at www.tricare.mil/pharmacy.
You do not need to file pharmacy claims for prescriptions filled at military pharmacies, through TRICARE Pharmacy Home Delivery, or at TRICARE retail network pharmacies. However, if you fill a prescription at a non-network pharmacy in the United States or U.S. territories, you must pay the full price of your prescription up front and file a claim for reimbursement. To file a claim:
- Download the claim form from our site.
- Complete the form and attach the required paperwork as described on the form.
- Mail the form and paperwork to:
Express Scripts, Inc.
P.O. Box 52132
Phoenix, AZ 85072
Prescription claims require the following information for each drug:
- Patient’s name
- Prescription name, strength, date filled, days’ supply, quantity dispensed, and price
- National Drug Code, if available
- Prescription number
- Name and address of the pharmacy
- Name and address of the prescribing physician
- Shipping invoice from OHI mail order pharmacy, if applicable
- Explanation of benefits from OHI, if applicable