TRICARE Mail Order Pharmacy Changes: 2026 Guide | TRICARE.com

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## Quick answer Most TRICARE mail-order pharmacy operations remain stable under Express Scripts, but the major recent change involves the transition to the **T-5 contract** (effective January 1, 2025), which shifted West Region management to TriWest Healthcare Alliance. While Express Scripts continues to manage mail order, beneficiaries may see changes in brand-name drug classifications and increased incentivization to move maintenance medications from retail pharmacies to home delivery to save on 2026 copayments.

Details

### The T-5 Transition and Mail Order While **Express Scripts** remains the national Pharmacy Benefit Manager (PBM) for TRICARE, the 2025 T-5 contract transition moved the West Region from Health Net Federal Services (HNFS) to **TriWest Healthcare Alliance**. If you are in the West Region, your mail-order prescriptions integrated into a new regional portal, though your actual medication shipments still originate from Express Scripts facilities.

### 2026 Pharmacy Choice Changes TRICARE continues to enforce the "Maintenance Drug Transition" rule. If you take "maintenance medications" (long-term drugs for conditions like high blood pressure or cholesterol) and fill them at a retail pharmacy, you are generally allowed two fills at the retail price. After that, you must switch to **TRICARE Pharmacy Home Delivery** or a military pharmacy, or you will be responsible for 100% of the cost.

### Pharmacy Copayments (2026 Rates) Copayments for mail order remain the most cost-effective option for beneficiaries (other than free refills at a Military Treatment Facility). As of 2026, the typical 90-day mail-order costs are: * **Generic Formulary:** $16 * **Brand-Name Formulary:** $43 * **Non-Formulary:** $92 (unless medical necessity is established) * **Active Duty Service Members:** $0 for all covered drugs.

### Changes to "Specialty" Pharmacy Specialty medications (complex drugs for conditions like cancer or MS) are now almost exclusively handled through the **Accredo** specialty pharmacy, which is a division of Express Scripts. Beneficiaries can no longer utilize most local retail pharmacies for these specific high-cost medications if they want to maintain TRICARE coverage.

### Digital Enhancements In 2026, Express Scripts has streamlined the "e-Prescribe" process. Doctors can now send 90-day prescriptions directly to "TRICARE Home Delivery" electronically, bypassing the need for patients to mail in paper scripts or manually upload scans to the portal.

## Who this affects * **Retirees and their families:** Historically the group most impacted by mail-order mandates and copay increases. * **Active Duty Family Members (ADFMs):** Encouraged (but not always mandated) to use mail order for maintenance meds. * **TRICARE Reserve Select & Retired Reserve:** Follow the same copay and mail-order structure as active duty families and retirees respectively. * **TRICARE For Life (TFL) beneficiaries:** Heavily reliant on mail order to avoid the higher retail costs associated with the TRICARE/Medicare overlap.

## Sources * **TRICARE.mil Pharmacy Page:** https://www.tricare.mil/pharmacy * **Express Scripts TRICARE Portal:** https://militaryrx.express-scripts.com/ * **Defense Health Agency (DHA):** https://health.mil/ * **TriWest Healthcare Alliance (West Region):** https://www.triwest.com/