Healthcare Professionals

Providers

We’ll work with you to get your patient the medication they need at the best possible price. 

How patients get medication

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We can deliver 90-day supplies of maintenance medications to TRICARE patients, wherever they are. Express Scripts Pharmacy® sends medication in secure, weather-resistant packaging. Free standard delivery is included in the benefit. 

Patients also have the option to pick up most medication at a military treatment facility (MTF) or a retail pharmacy. Patients get up to 90-day supply at an MTF and up to a 30-day supply at retail pharmacies. An MTF has no copay. Home delivery and retail pharmacies might require a copayment. Patients can see their costs by searching Covered Medications. 

You can quickly and securely send a prescription to us electronically through e-prescribing. Learn more

Resources to help MTFs prevent misuse of prescription medication

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The Prescription Monitoring Program works with MTFs and TRICARE Managed Care Support Contractors to identify patients at risk of misusing prescription drugs. At risk patients may have their pharmacy benefit restricted in order to prevent or decrease drug seeking behavior. 

Email: TRICARE111@express-scripts.com

The Prescription Drug Monitoring Program (PDMP) is a data base that allows  providers access to complete information prior to prescribing controlled substances. With it, you can see if a Schedule II-V medication (e.g., opioid, anabolic steroid, sleep medication, or ADHD medication) was recently prescribed to your patient from another prescriber or military treatment facility.

How to prescribe medication for a patient who is deploying

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When a patient is deploying, they may get up to a 180-day initial supply.  Refills of their medication can be delivered through the Deployment Prescription Program (DPP).

We’ll work with you to make sure your patient gets their therapy while deployed. Learn more about getting started and prescription requirements.

Email: DeployedPrescriptionProgram@express-scripts.com
Phone: (855)215-4488

How to use Real-Time Prescription Benefit for TRICARE patients

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Real-Time Prescription Benefit provides patient-specific pharmacy benefit information in less than two seconds. You must have Real-Time Prescription Benefit functionality embedded in your Electronic Health Record (EHR).

When you create a new prescription, the tool displays data about coverage and costs for therapeutic options. It helps you answer patients’ questions about drug coverage and available alternatives.

Learn more from the Real-Time Prescription Benefit Overview.

Pharmacists

We’ll work with you to get your patient the medication they need.

What to do if a patient has other health insurance (OHI)

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The patient’s OHI is the primary payer for prescriptions and TRICARE is the secondary payer, except in certain conditions.

When filling a prescription, you can submit to both insurance plans at the same time to reduce the patient’s cost and make sure they don’t need to file a paper claim.
 

How deploying patients get medication

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When a patient is deploying, they may get up to a 180-day initial supply and then can get medication delivered by the Deployment Prescription Program. Learn more

Resources to help MTFs prevent misuse of prescription medication

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The Prescription Monitoring Program works with MTFs and TRICARE Managed Care Support Contractors to identify patients at risk of misusing prescription drugs. Providers can request restrictions for identified patients.

Email: TRICARE111@express-scripts.com

The Prescription Drug Monitoring Program (PDMP) is a database that allows  pharmacists access to complete information prior to dispensing controlled substances. With it, you can see if a Schedule II-V medication (e.g., opioid, anabolic steroid, sleep medication, or ADHD medication) was recently prescribed to your patient from another prescriber or military treatment facility.

Email: MHSPMP@express-scripts.com
Access: https://mhs.pmpaware.net/login