04 Sep Costs of Tricare Pharmacy
Find out how much it is going to Costs of TRICARE Pharmacy to get your prescription filled from TRICARE based on the military status of your sponsor, the type of drug you need and where you get your prescription filled from.
Under the TRICARE Pharmacy plan, prescription Costs of TRICARE Pharmacy depend upon three factors:
- Military status of sponsors
- Location where prescription medications are refilled
- Type of drug needed
Costs of TRICARE Pharmacy Overview
Active Duty Service members can get their prescription filled from any pharmacy with no charges. However, there may be instances when some costs might have to be paid directly when buying from certain network and non-network service providers. Express Scripts is the official partner of TRICARE pharmacy, if and when any expenses were born personally, filing a claim with the latter will help in getting complete reimbursement. Moreover, in order to get non-formulary drugs for free, the medical advisor needs to establish proof of necessity.
Other beneficiaries of TRICARE pharmacy include Guard/Reserve and Retired members and their dependents. For them, TRICARE pharmacy is also essentially free, but charges may still apply, depending on the method and location of prescription filing. The type of drug is also taken into account. When getting medications directly from Medical Treatment Facilities (MTFs) there are no charges for generic drugs and brand name drugs, even after the initial period of 90 days. Further, no co-payment is needed while purchasing and refiling from the Medical Treatment Facilities.
When using the home delivery service method, generic, branded and most other prescription drugs are free of cost. After a period of 90 days, generic drugs are still cost-free while, brand name drugs require a co-payment of $16. Non-formulary drugs, which require proof of medical necessity, will cost up to $46.
When using the services of a network pharmacy, it is relatively more expensive. You get an initial 30 day period of free prescription drugs. Generic and non-formulary drugs are costly no matter what. Even in the thirty day period, generic formulary drugs cost you up to $8 and branded formulary drugs will cost you $20.
Under the coverage of TRICARE Prime and TPRADFM, Point of Service fees apply; 50% cost share is required after the Point of Service deductible amount is covered. While on TRICARE Standard and TRICARE Extra; $17 or 20 % of the total cost is required to be paid after the annual deductible amount is met.