Formulary

The formulary is TRICARE's official list of prescription drugs that are covered under the pharmacy benefit. Managed by the Department of Defense Pharmacy and Therapeutics Committee, the formulary categorizes medications into tiers that determine your copay amounts.

Formulary drug tiers: • Generic formulary: Lowest copay, widely available generic medications • Brand-name formulary: Moderate copay, preferred brand-name drugs • Non-formulary: Highest copay, drugs not on the preferred list • Non-covered: Not covered by TRICARE pharmacy benefit

Where formulary status matters: • MTF pharmacies: Most formulary drugs available at $0 • Home delivery: Low copays for 90-day supplies • Retail pharmacies: Copays vary by tier and supply length • Non-network pharmacies: Highest out-of-pocket costs

Key points about the formulary: • Updated regularly by the DoD P&T Committee • Prior authorization may be required for some medications • Step therapy protocols may apply • Generic alternatives are encouraged when available • Non-formulary drugs require prior authorization at retail or home delivery

Always check the formulary before starting a new medication to understand your costs and coverage options. Your provider can prescribe formulary alternatives to help minimize your pharmacy expenses.