The TRICARE Uniform Formulary (UF) is a list of brand name and generic drugs and supplies that TRICARE covers. The formulary is:
You can search the TRICARE Formulary to:
- Look up costs, quantity limits and therapeutic alternatives
- Download medical necessity or prior authorization forms
- Check the formulary status of your prescription and see the expected copays.
Search the TRICARE Formulary
A non-formulary drug can be provided at the formulary cost share if your provider supplies information showing that there is a medical necessity to use the non-formulary drug instead of a therapeutic alternative.
Frequently Asked Questions
View questions and answers about the TRICARE Formulary.
Q2:
How do I know if there is a generic medication available for my prescription?
A:
You can find out if a generic version of your prescription is available by looking it up on the Formulary Search Tool. In general, and FDA approved generic medication is required to be dispensed over the branded version. If your provider requests that a brand be dispensed instead of the generic they will need to call the Express-Scripts prior authorization line at 1-866-684-4488 to establish medical necessity or they can fill out the Brand over Generic Prior Authorization Request Form and fax it to Express-Scripts.
Q3:
Is my medication covered by TRICARE?
A:
You can find out if your medication is covered and what the copay will be by looking it up on the Formulary Search Tool.
The Formulary Search Tool lists any coverage rules (such as prior authorization or medical necessity) and copays at different points of service (military pharmacy, retail network pharmacy, or TRICARE mail order pharmacy).
Q5:
What if it is medically necessary for me to receive a non-formulary medication rather than a formulary therapeutic alternative?
A:
Medical necessity does not need to be established for family members and retirees to receive a non-formulary drug at a retail network pharmacy or at the TRICARE mail order pharmacy. Non-formulary copays will apply.
If your provider considers it medically necessary for you to receive the non-formulary drug rather than a formulary therapeutic alternative, you may be able to pay a lower copay. Your provider may call the Express Scripts prior authorization line at 1-866-684-4488 to establish medical necessity, or they may fill out the medical necessity form that is linked to that medication on the Formulary Search Tool and fax it to Express-Scripts.
For active duty service members, medical necessity is required to receive a TRICARE non-formulary drug.
Military pharmacies do not typically stock or dispense non-formulary medications. If you are enrolled to the military clinic and referred out to a civilian provider who prescribes a non-formulary medication, contact your military pharmacy for options.
Medical necessity forms and prior authorization are separate forms and both may be required. If a prior authorization is listed in the "Notes" section of the Formulary Search Tool, the prior authorization must be approved before medical necessity requirements.
Q6:
Is there an age restriction on my medication?
A:
You can find out if there are age restrictions on your medication by looking it up on the Formulary Search Tool. These will be listed under the "Notes" section.
If your provider wants to prescribe outside the age restrictions, they can call the Express Scripts prior authorization line at 1-866-684-4488 to request an override.
Q7:
Are there quantity limits on my medication?
A:
You can find out if there are quantity limits on your medication is covered by looking it up on the Formulary Search Tool. These will be listed under the "Notes" section.
If your provider wants to prescribe more than the quantity limit, they can call the Express Scripts prior authorization line at 1-866-684-4488 to request an override.
Q9:
Does my medication require a prior authorization?
A:
You can find out if your medication requires prior authorization by looking it up on the Formulary Search Tool. These will be listed under the "Notes" section. The copay listed is based on an approved prior authorization.
If a prior authorization is required, your provider can call the Express Scripts prior authorization line at 1-866-684-4488, submit a prior authorization electronically, or fill out the prior authorization form that is linked to that medication on the Formulary Search Tool and fax it to Express-Scripts.
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Effective immediately, all Department of Defense (DoD) military treatment facility (MTF) outpatient pharmacies will accept patient requests for prescription transfers from another MTF and from retail pharmacies. When another pharmacy requests prescription transfer information on behalf of a patient, DoD MTF outpatient pharmacies will respond to the inquirer in a timely manner.
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Questions have arisen concerning the requirement for military treatment facilities (MTFs) to provide medications prescribed by MTF providers. This requirement has commonly been referred to as the "You write it, you fill it" policy.
- Identification #: HA Policy 04-032
- Date: 3/22/2005
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