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Military Advantage

TRICARE Rx Co-Pay Increase

On Friday, February 1, 2013, many TRICARE beneficiaries saw an increases in their prescription costs.  Here is a quick run down on the new TRICARE medication co-pays:

Mail Order - Your new co-pay rates for TRICARE Home Delivery (Mail Order) medications changed as follows (for up to 90-day supplies):

  • $0 for generic formulary medications - unchanged
  • $13 for brand-name formulary medications  - increased by $4
  • $43 for non-formulary medications - increased by $18
Network Pharmacy - Your new co-pay rates for Network Pharmacy medications changed as follows (for up to 30-day supplies):
  • $5 for generic formulary medications – unchanged.
  • $17 for brand-name formulary medications – increased by $5
  • $44 for non-formulary medications – increased by $19
Note: If you want to have a 90-day prescription filled, you will pay the copayment for each 30-day supply.

Non-Network Pharmacy - Your new co-pay rates for prescriptions filled at non-network pharmacies medications (including host nation pharmacies) and costs will vary based on your plan and the type of prescription.

  • TRICARE Prime enrollees will pay 50% cost share after the point of service deductible is met.
  • TRICARE Standard/Extra, TRICARE Reserve Select, TRICARE Retired Reserve or TRICARE Young Adult enrollees will pay:
    • Formulary-Generic or Brand Name: $17 or 20% of the total cost, whichever is greater, after the annual deductible is met
    • Non-Formulary $44 or 20% of the total cost, whichever is greater, after the annual deductible is met
Military Pharmacies - If you receive your medications through a Military Pharmacy you will continue to get your medications with no co-pay. However, not all medications are available at military pharmacies. For example non-formulary medications are not usually filled at military pharmacies. You should call to check availability. Show Full Article

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