What is the TRICARE formulary?

The TRICARE formulary is the comprehensive list of prescription medications that are approved and covered under the TRICARE pharmacy benefit. Managed by the Department of Defense Pharmacy and Therapeutics Committee, the formulary organizes medications into three tiers that determine the beneficiary's copay amount. Tier 1 includes generic medications with the lowest copays ($0 at military pharmacies and home delivery). Tier 2 includes brand-name formulary medications with moderate copays. Tier 3 includes non-formulary brand-name medications with the highest copays. The formulary is regularly updated as new medications become available and existing medications are evaluated for safety, efficacy, and cost-effectiveness. Some medications require prior authorization before TRICARE will cover them, and certain drugs may have quantity limits. Beneficiaries and providers can search the formulary online at the Express Scripts website to check whether a specific medication is covered and at what tier. If a non-formulary medication is prescribed, beneficiaries may request a formulary exception through their provider if medically necessary.