Steps to Filling Your TRICARE TMOP Prescription
Step 1: Register to use the TMOP.
The first time you use the TMOP you must fill out a TMOP mail-order registration form and send it to Express Scripts, the TMOP contractor, along with your prescription and co-payment. You must complete this form only one time, unless your health condition changes. If you have registered at TMOP online recently or mailed a registration form, you do not need to re-register.
There are three ways to register:
1. Call Express Scripts:
2. Download and mail the form from the Express Scripts Web site, www.express-scripts.com/custom/dod/ben_message/.
3. On-line at the Express Scripts Web site, www.express-scripts.com/custom/dod/ben_message/.
Ask your provider to write a prescription for up to a 90-day supply with up to three refills, if possible.
If you must begin a prescription medication right away, ask your provider to write two separate prescriptions for the same medication:
A one-month supply for you to fill immediately at a local retail network pharmacy; and a long-term supply for you to fill through the TMOP.
You may refer to www.tricareformularysearch.org to confirm the formulary status of your medication and to check the co-payment amounts due before sending your prescriptions and co-payment.
Note: While you wait for your mail-order shipment, begin taking the medication you obtained from the local retail network pharmacy.
Certain medications may have a 30-day quantity limit and/or require medical necessity or prior authorization from your provider.
Mail your health care provider's written prescription with your registration form and co-payment to Express Scripts, P.O. Box 52150, Phoenix, AZ 85072-9954.
You must enclose a co-payment for each prescription you send to the TMOP. For example, if you are an active duty family member or retiree sending the TMOP two separate prescriptions for generic medications, your total cost would be $6 (i.e., two $3 co-payments).
You may pay by check or money order, payable to Express Scripts. The easiest way to ensure you pay the correct co-payment is to authorize TMOP to bill your Visa, MasterCard, Discover or American Express account. You do not have to pay shipping or handling.
Note: If you are on active duty there are no co-pays to use the TMOP.
Allow about 14 days from the day Express Scripts receives your initial prescription to the time your medication arrives at your door.
How to Fax a New Prescription
You may also ask your provider to fax your written prescription toll-free to Express Scripts at 1-877-895-1900. Here's how:
If your provider faxes a prescription on your behalf, you may pay your co-payment the following three ways:
After the provider faxes the prescription, please wait 48 hours before calling Express Scripts to ensure your order is in the system.
How to Refill a Prescription
You may request your refill by mail, telephone or the Express Scripts Web site. Check the label of your current TMOP medications for the date you should request a refill. You must pay for orders you place by telephone or online by check or credit card. The TMOP delivers your medications usually within 14 days from the date it receives your refill request.
If you forget to request a refill on time, you may request expedited shipping and handling services for an additional charge.
TMOP and Other Health Insurance
You may only use the TMOP with other health insurance (OHI) if you meet one of the following conditions:
If your OHI has a pharmacy benefit, use a TRICARE retail network pharmacy to maximize your TRICARE pharmacy benefit. Ask the pharmacy if they will process your prescription with your OHI first, then TRICARE second. In most instances, you will leave the pharmacy with no out-of-pocket expenses and no claim to file. If your pharmacy cannot coordinate your OHI and TRICARE pharmacy benefits, you must file a claim to get full or partial reimbursement for your out-of-pocket expenses. You must mail a completed TRICARE Claim Form DD2642 and your other health insurance?s explanation of benefits showing payment to:
Attn: TRICARE Claims
P.O. Box 66518
St. Louis, MO 63166-6518
You have one year from the date you purchased your medication to file for reimbursement with Express Scripts. If you have a question about the DoD Retail Pharmacy Program you may call 1.866.DOD.TRRX (1.866.363.8779). Customer service representatives are available 24 hours a day, 7 days a week.
TMOP Requirements for Beneficiaries Living Overseas
The TMOP cannot mail prescriptions to any private foreign address. If you reside overseas, you must meet the following requirements to receive mail-order delivery:
Note: The TMOP will not ship refrigerated medications to any APO/FPO address. If you require refrigerated medication, talk to your licensed overseas provider about alternatives.
For More Information
A licensed pharmacist is available to answer questions about your medications 24 hours a day at 1-866-363-8667; or TDD at 1-877-540-6261. TRICARE Enrollment and Claims forms can be found at: www.tricare.mil/enrollment/index.cfm.
For general information about TRICARE, call the toll-free TRICARE information line for your region found at the TRICARE Contact Us web page.
Plan would impact retiree's benefits