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Maintenance Drug Prescriptions With TRICARE

Mario Blount, pharmacy technician, verifies prescription labels at the David Grant USAF Medical center pharmacy. (Photo: U.S. Air Force/ Staff Sgt. Liliana Moreno)
Mario Blount, pharmacy technician, verifies prescription labels at the David Grant USAF Medical center pharmacy. (Photo: U.S. Air Force/ Staff Sgt. Liliana Moreno)

TRICARE has made changes to the way they provide "maintenance drugs". Maintenance drugs are those you use on a regular basis for chronic health conditions (e.g., high cholesterol, blood pressure). These do not include medications needed for a sudden illness or infection.

New TRICARE Pharmacy Rule

You must refill select maintenance drugs through home delivery via TRICARE's home-delivery pharmacy, Express Scripts. You can also refill maintenance drugs at military pharmacies. This doesn't apply to active duty service members.

When you get a prescription for a drug on the select maintenance drug list you can fill it up to twice at a network pharmacy, after that, you need to switch it to home delivery or to a military pharmacy. If you continue to fill your prescription at a network pharmacy, you'll pay the full cost.

Exceptions to the Rule

If you use generic maintenance drugs you are exempt from this rule, you can continue to fill your prescriptions at a network pharmacy.

If you live overseas you are not required to use the mail-order pharmacy. this requirement only applies to prescriptions filled in the U.S. and U.S. Territories.

TRICARE and Express Scripts also provide waivers in individual cases due to:

  • Emergencies
  • Personal needs
  • Special circumstances, such as living in a nursing home

Active duty members are not affected by this rule.

See the TRICARE Website for more information.

 

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