Changes to the TRICARE pharmacy network

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A group of retail pharmacies left the TRICARE network on 24 October 2022. If you are directly impacted, you have been notified by letter. If you continue to fill your prescriptions at a pharmacy leaving the network, you will pay the full price for your medication[i]. This change applies to all medications, including specialty medications.[ii]

TRICARE covers your prescriptions at the point of service when obtained at home delivery, at military pharmacies and at in-network retail pharmacies.

If you would like to continue to use a local pharmacy that will no longer be part of the TRICARE retail pharmacy network, you will be required to pay full price for the prescription drug and file a claim for reimbursement. Reimbursements are subject to deductible or out-of-network cost-shares, and copayments. All deductibles must be met before TRICARE can reimburse the beneficiary. Learn how to file a claim online.

Home delivery through Express Scripts® Pharmacy is a great option for medications you take on a regular basis. There are three easy ways to move your prescription to home delivery:

  • Call your doctor’s office. Ask them to send a prescription electronically to Express Scripts Home Delivery for up to a 90-day supply of your medication.
  • Log in or register to find copayment information and move eligible prescriptions. You can also use the Express Scripts Pharmacy Mobile App®.
  • Call 1.877.363.1303 and select option 3. We will take care of everything for you.

You can move your prescriptions to an in-network retail pharmacy. This is the best option for medications taken on a one-time basis. You can find an in-network retail pharmacy by using the find a pharmacy tool. To move your prescription to an in-network retail pharmacy:

  • Call your doctor’s office. Ask them to send your prescription electronically to your new in-network retail pharmacy.

OR

  • If your prescription still has a refill available, call your new in-network retail pharmacy and ask them to transfer your prescription.

To compare your prescription costs at in-network retail pharmacies and at home delivery, use the online Price a Medication tool. Login to your online account or download the Express Scripts® mobile app to use the tool.

You may also choose to go to a military pharmacy.

Important to know if you are filling specialty medications

Effective 1 January 2023, Accredo will be the primary pharmacy for TRICARE beneficiaries filling specialty medications at retail pharmacies. To help you get started ahead of this date, Accredo is available to you today. With Accredo, you will have 24/7 access to personalized care and support from specialty-trained pharmacists and nurses. To move your prescriptions to Accredo, call 1.877.882.3324 and an Accredo patient care advocate will work with you and your doctor. Visit accredo.com/dodspecialty for more information.

You may also choose to fill your eligible specialty medications at home delivery through Express Scripts® Pharmacy or at a military pharmacy. Visit the TRICARE formulary search tool to see where your specialty medications are covered.

We are here to help you. Contact us and we will help answer any questions you may have.

 

 

 

 

 

 

[i] There are no changes to copayments because of this network change. If you continue to fill your prescription at a non-network pharmacy, you may file a claim for reimbursement. Reimbursements are subject to deductible or out-of-network cost-shares, and copayments.

[ii] A specialty medication is a medication used to treat chronic, complex conditions such as multiple sclerosis, rheumatoid arthritis, hepatitis C and cancer. Specialty medications can include drugs that are more complex to administer such as injected, infused or inhaled medications and may require special handling, such as refrigeration.

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