What are TRICARE prescription copays?
Quick Answer
Prescription copays range from $0 at military pharmacies to $14-$68 at retail depending on drug tier. Home delivery offers 90-day supply at lower cost.
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Key Takeaways
- MTF pharmacy is $0
- Home delivery cheaper than retail
- Active duty pays $0 everywhere
- Copays count toward catastrophic cap
Detailed Answer
Prescription costs vary by pharmacy location and drug tier.
Military Pharmacy (MTF)
- Generic: $0
- Brand formulary: $0
- Non-formulary: Not dispensed
Home Delivery (90-day)
- Generic: $0
- Brand formulary: $20
- Non-formulary: $68
Network Retail Pharmacy (30-day)
- Generic: $14
- Brand formulary: $38
- Non-formulary: $68
Non-Network Retail
- Pay full cost upfront
- File claim for reimbursement
- Reimbursed at network rates
- Higher out-of-pocket
Active Duty Members
- $0 at all sources
- No copays for any medication
Catastrophic Cap
- Pharmacy copays count toward cap
- Once cap met, no more copays
- Resets annually
Related TRICARE Terms
Related Questions
How does the TRICARE catastrophic cap work?
The catastrophic cap is your maximum annual out-of-pocket cost. Once reached, TRICARE pays 100% of covered services for the rest of the fiscal year.
How much do prescriptions cost with TRICARE?
Prescription costs vary by location: military pharmacies are free, network pharmacies charge $13-$60 copays, and home delivery offers lower costs for 90-day supplies.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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