Higher TRICARE Pharmacy Costs in 2026
TRICARE beneficiaries will see higher pharmacy costs in 2026. The TRICARE Pharmacy Program implements new prescription drug copayments starting January 1, 2026, affecting “most beneficiaries,” according to TRICARE.mil.
The National Defense Authorization Act for Fiscal Year 2018 established the pricing structure that governs these copayments through December 31, 2027.
Higher TRICARE Pharmacy Costs in 2026
Several factors influence a beneficiary’s final cost for prescription drugs. These factors include the beneficiary’s specific TRICARE category, the drug’s placement on the TRICARE Formulary, and the type of pharmacy used to fill the prescription.
TRICARE categorizes prescription drugs into four primary groups. Generic formulary drugs cost the least, followed by brand-name formulary drugs, which carry a higher copayment.
Non-formulary drugs represent the third, most expensive tier. Beneficiaries must pay the full cost for non-covered drugs. A provider may establish medical necessity for a non-formulary drug; if TRICARE approves the authorization request, the beneficiary pays the formulary cost instead of the higher non-formulary rate.
Exempt Beneficiary Categories
TRICARE exempts several populations from these pharmacy cost increases. Active duty service members will pay nothing for all covered drugs, regardless of whether they use a military pharmacy, home delivery, or a retail network pharmacy.
Survivors of active duty service members and medically retired service members, along with their family members, will see no change in their copayments during the 2026 calendar year. All other TRICARE beneficiaries will experience cost increases across most categories.
Cost Changes for Home Delivery
TRICARE Pharmacy Home Delivery offers beneficiaries the option to receive up to a 90-day supply of their medication. Copayments for this option will change across all three covered drug categories.
For the least expensive medications, generic formulary drugs, the copayment will increase by one dollar, moving from thirteen dollars to fourteen dollars per prescription.
Brand-name formulary drugs may experience a larger increase. Beneficiaries currently pay $38 for this drug tier; the new copayment will rise to $44, an increase of $6.
The largest increase applies to non-formulary drugs. The cost of these medications will increase by $9, from $76 to $85 per prescription.
Cost Changes for Retail Network Pharmacies
Beneficiaries often use TRICARE retail network pharmacies for convenience and to fill a 30-day supply of medication. Copayment adjustments apply differently in this setting.
Generic formulary drugs remain the only category in which costs do not increase. Beneficiaries will continue to pay sixteen dollars for a 30-day supply of a generic formulary drug at a retail network pharmacy.
The cost of brand-name formulary drugs will increase by $5. The current $43 copayment has increased to $48 per 30-day prescription.
Non-formulary drugs filled at a retail network pharmacy will be charged at the home delivery cost. The copayment will increase from $76 to $85, a $9 adjustment.
Non-Network Pharmacy Rules and Costs
Using a non-network pharmacy alters how TRICARE calculates costs and how beneficiaries handle payment.
Beneficiaries with a TRICARE Prime plan will not see changes in their non-network pharmacy costs. They must first satisfy the point-of-service deductible for covered drugs. After meeting this deductible, they pay a fifty percent cost-share for the covered drug.
Beneficiaries using other TRICARE plans will pay a copayment or cost-share after meeting their annual deductible. For generic and brand-name formulary drugs, the cost will be $48 or 20% of the cost, whichever is greater.
This represents a five-dollar increase over the previous forty-three-dollar rate. For non-formulary drugs, there is an increase to $85 or 20% of the total cost, whichever is greater.
One important distinction for non-network pharmacies? The beneficiary must pay the full price for the drug upfront, then file a claim for reimbursement. Reimbursements remain subject to applicable deductibles, copayments, and cost-shares.
About the author
Editor-in-Chief Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter/editor for Air Force Television News and the Pentagon Channel. His freelance work includes contract work for Motorola, VALoans.com, and Credit Karma. He is co-founder of Dim Art House in Springfield, Illinois, and spends his non-writing time as an abstract painter, independent publisher, and occasional filmmaker.
