Those receiving prescription drugs through the TRICARE Pharmacy program will see increased copays in 2024. The increases are, according to a press release at TRICARE.mil, mandated by the National Defense Authorization Act passed in 2018.
TRICARE Pharmacy copay increases in 2024 range between $1 and $8, as we’ll explore below.
Who is Affected by TRICARE Pharmacy Cost Increases in 2024
Some TRICARE beneficiaries won’t see any increases at all. Others may experience modest increases in costs starting on January 1, 2024:
- Active duty service members pay no out-of-pocket costs for prescriptions.
- Survivors of active duty and medically retired service members: Copayments do not change in 2024.
- All other beneficiaries: Your copayments will increase in 2024.
Related: Ultimate TRICARE Guide
What to Know About TRICARE Pharmacy Costs in 2024
There are important aspects about TRICARE prescriptions to remember if you are new to the program. Below, you’ll find costs broken down by category. For example, generic formulary drugs are the least expensive. But what does “formulary” mean? Do non-formulary drugs cost more?
According to TRICARE, generic drugs are “just as potent, pure, safe, and reliable as brand-name drugs. The Food and Drug Administration (FDA) requires that all generic drugs pass strict testing to prove they are the same.”
A generic “formulary” drug refers to a medication found on the list of drugs covered by a healthcare plan.
Here is the definition of “non-formulary drugs” as described by GoodRX.com:
“Non-formulary drugs typically only include brand-name medications and come with high out-of-pocket expenses.” TRICARE covers non-formulary drugs but restrictions may apply depending on the medication and other variables.
TRICARE Pharmacy Home Delivery Fees
The following costs apply to prescriptions filled with a three-month supply:
- Generic “formulary drugs” increase from $12 to $13.
- Brand-name formulary drugs will rise from $34 to $38.
- Non-formulary drugs increase from $68 to $76.
How to Register for TRICARE Home Delivery
You can sign up for TRICARE Pharmacy Home Delivery in one of three ways:
- Sign Up Online via Express Scripts
- Sign up by phone by calling 1-877-363-1303 or TDD/TTY 1-877-540-6261
- Sign up by regular mail: Express Scripts, P.O. Box 52150 Phoenix, AZ 85072-2150
TRICARE Retail Network Pharmacy Fees in 2024
These costs are for a one-month supply of medication.
- Generic formulary drugs increase from $14 to $16.
- Brand-name formulary drugs increase from $38 to $43.
- Non-formulary drugs increase from $68 to $76.
TRICARE Non-Network Pharmacy Fees in 2024
Those with TRICARE Prime will see no changes in non-network pharmacy costs. These beneficiaries have a 50% cost share for non-network pharmacies and is paid after you meet the deductible.
All other TRICARE plans require a copayment or cost-share after meeting your annual deductible. The following fees are for a one-month supply of medication.
- Generic and brand-name formulary drugs increase from $38 to $43 or 20% of the total cost, whichever is greater.
- Non-formulary drugs increase from $68 to $76 or 20% of the total cost, whichever is greater.
What to Know About Non-Covered Prescriptions Under TRICARE
If you need a prescription drug not covered by TRICARE, Express Scripts will send you a letter and return your prescription. To avoid delays, you can check if a prescription is covered by calling Express Scripts at 1-877-363-1303.
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