TRICARE Prescriptions: Costs, Coverage & Tiers (2026) | TRICARE.com

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## Quick answer TRICARE offers four ways to fill prescriptions: military pharmacies ($0 cost), home delivery via Express Scripts (lowest cost for brand names), retail network pharmacies (convenient but higher copays), and non-network pharmacies (highest cost). Your specific out-of-pocket costs depend on your beneficiary status, your plan (Select vs. Prime), and the drug's "tier" on the TRICARE formulary.

In detail

The TRICARE pharmacy benefit is managed globally by **Express Scripts**. Regardless of which medical plan you have (Prime, Select, Reserve Select, for Life), you use the same pharmacy program.

### 1. The Four Filling Options * **Military Pharmacies:** Most generic and brand-name drugs on the basic formulary are available at **$0 copay**. This is always the most cost-effective option for beneficiaries. * **TRICARE Pharmacy Home Delivery:** Managed by Express Scripts. You receive a 90-day supply of "maintenance medications" (drugs you take regularly) delivered to your door. This is the mandatory delivery method for certain brand-name maintenance drugs for Select/Prime users. * **Retail Network Pharmacies:** Over 50,000 pharmacies nationwide are in the TRICARE network. You pay a copay for a 30-day supply. * **Non-Network Pharmacies:** You pay the full price upfront and file a claim for partial reimbursement. This is significantly more expensive and may involve meeting a deductible first.

### 2. Drug Tiers and Costs (2026 Rates) TRICARE categorizes drugs into four tiers. Prices typically increase every two years; the following are the 2026 rates for most Active Duty Family Members and Retirees:

| Drug Tier | Military Pharmacy (90-day) | Home Delivery (90-day) | Retail Network (30-day) | | :--- | :--- | :--- | :--- | | **Tier 1: Generic** | $0 | $13 | $16 | | **Tier 2: Brand Name** | $0 | $38 | $43 | | **Tier 3: Non-Formulary** | Not Available* | $76 | $76 | | **Tier 4: Non-Covered** | No Coverage | Full Cost | Full Cost |

*\*Tier 3 drugs are rarely stocked at military pharmacies unless there is a specific medical necessity waiver.*

### 3. Special Rules and Limitations * **Active Duty Service Members (ADSMs):** Always have a $0 copay for all covered drugs at any pharmacy. * **Maintenance Medications:** Under the "Maintenance Drug Program," most beneficiaries must use Home Delivery or a military pharmacy for certain long-term medications after the second fill at a retail pharmacy. If you continue using a retail pharmacy for these specific drugs, you may be responsible for the full cost. * **The Formulary Search Tool:** You should always use the [Express Scripts Formulary Search Tool](https://www.express-scripts.com/tform) to see if a drug is covered and what tier it falls into before visiting a doctor.

## Who this applies to * **Active Duty Service Members:** $0 cost-share at all locations; must coordinate through military clinics when possible. * **Active Duty Family Members:** Pay standard copays at retail/home delivery; $0 at military pharmacies. * **Retirees and their Families:** Subject to standard copays; must use home delivery for certain maintenance drugs. * **TRICARE Reserve Select/Retired Reserve:** Follow the same cost structure as Active Duty Family Members. * **TRICARE For Life (TFL):** TRICARE acts as the primary payer for pharmacy even though Medicare is primary for medical; must follow TRICARE pharmacy rules to keep costs low.

Common scenarios

**Scenario A: High-Blood Pressure (Generic Maintenance)** John is a Navy retiree living in Florida. He takes Lisinopril (Generic). He can get a 90-day supply at his local Military Treatment Facility for **$0**. If he chooses Express Scripts Home Delivery, he pays **$13** for the same 90-day supply (2026 rates).

**Scenario B: Acute Infection (Antibiotic)** Sarah, an Army spouse, gets a refill for Amoxicillin after a dental procedure. She goes to a network CVS. She pays **$16** for a 30-day supply (2026 rates). Because this is an acute (short-term) need, it is not eligible for home delivery.

**Scenario C: Non-Formulary Specialty Drug** Mark is a retiree taking a specific brand-name drug not on the TRICARE formulary. He uses home delivery. He pays **$76** for a 90-day supply (2026 rates), provided his doctor submitted a "medical necessity" form to Express Scripts.

## Related terms * **Formulary:** The official list of brand-name and generic drugs covered by the TRICARE pharmacy benefit. * **Maintenance Medication:** A drug you take regularly for chronic conditions (e.g., high blood pressure, cholesterol). * **Medical Necessity:** A form your doctor signs stating a specific Tier 3 drug is required because Tier 1 or 2 options were ineffective. * **Prior Authorization:** A requirement that your doctor get approval from Express Scripts before a specific drug can be covered. * **Quantity Limits:** Restrictions on how much medication you can receive in a specific timeframe.

## Sources * **TRICARE.mil Pharmacy Overview:** https://www.tricare.mil/pharmacy * **Express Scripts TRICARE Portal:** https://militaryrx.express-scripts.com/ * **TRICARE Formulary Search Tool:** https://www.express-scripts.com/tform * **DHA Pharmacy Operations:** https://health.mil/Military-Health-Topics/Business-Support/Pharmacy-Operations