Tricare Pharmacy Fees Set to Rise Feb. 1

Air Force Pharmacist fills prescription

All Tricare users except active duty troops will soon see higher fees for prescription drugs received by mail or at off-base retail pharmacies.

Prescriptions filled on-base will continue to be free.

The changes impact all non-active duty Tricare pharmacy users who receive drugs from any off-base pharmacy or who use the mail-order system. The price increases were ordered by Congress as part of the 2018 National Defense Authorization act.

Effective Feb. 1, a 90 day supply of generic drugs received through the system’s Express Scripts mail-order pharmacy will be $7, currently, those medications are free. Co-pays on brand name drugs received through the mail will go from $20 to $24 for brand name drugs and $49 to $53 for non-formulary ones.

For prescriptions filled at retail pharmacies a 30-day supply for generic drugs will increase from $10 to $11, brand names will go from $24 to $28, and non-formulary ones will go from $49 to $53.

Out of network pharmacy costs are also increasing. Users who buy drugs at those pharmacies or overseas must first meet their annual deductible, which vary by Tricare plan.

Tricare Prime users pay a 50 percent cost share for the drug after their point of service fee. All other users except active duty troops will pay 20 percent of the total cost or $24, whichever is more, for drugs on the formulary, and 20 percent of the cost or $53, whichever is more, for off-formulary drugs. Active duty troops will be reimbursed for any out-of-network pharmacy fees.

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