TRICARE Pharmacy

Army Reserve: Retired

Benefit Fact Sheet


TRICARE provides a pharmacy benefit to all eligible Soldiers, including beneficiaries entitled to Medicare Part A and B based on their age. Eligible beneficiaries may fill prescription medications at military treatment facility (MTF) pharmacies; through the TRICARE Express Scripts, Inc. (Express Scripts); at TRICARE retail network pharmacies; and at non-network retail pharmacies. Prescriptions filled through the MTF, TRICARE Pharmacy Home Delivery, and retail network pharmacies are checked for accuracy and are checked against your TRICARE prescription history for potential drug interactions. To have a prescription filled; beneficiaries need a written prescription and a valid Uniformed Services identification card.

DFAS will provide IRS Form 1095-C to all U.S. military members, and IRS Form 1095-B to all Retirees, Annuitants, former Spouses and all other individuals having TRICARE coverage during all or any portion of tax year 2020. An IRS Form 1095 documents you (and your Family members, if applicable) have the minimum essential coverage. These forms will document the information that DFAS will provide to the IRS on yourself and your authorized Family members. According to the IRS, these forms are not required to prepare or file income tax returns but will be available via myPay no later than 31 January 2021.


Retired Army Reserve Soldiers and their TRICARE eligible Family members are eligible for TRICARE Pharmacy Benefits; however, they do not obtain TRICARE eligibility until age 60.

Beneficiaries who turned 65 before 1 April 2001 may participate in the program without being enrolled in Medicare Part B. Beneficiaries who turn 65 on or after 1 April 2001 must be enrolled in Medicare Part B and must ensure their DEERS profile is updated to participate.

Benefit Highlights

TRICARE's mandatory generic drug policy requires that prescriptions be filled with a generic product if one is available. In the United States, all generic drugs must undergo Food and Drug Administration testing and approval, Pharmacist looking for medicineand are considered safe alternative to brand-name drugs.

Beneficiaries pay the pharmacy copayment based on whether the prescription medication is classified as a formulary generic (Tier 1), formulary brand name (Tier 2), or non-formulary (Tier 3) drug. The copayment depends on where the beneficiary chooses to fill their prescription.

All TRICARE-eligible beneficiaries who are registered in Defense Enrollment Eligibility Reporting System (DEERS) are automatically eligible for the retail network pharmacy option. This option allows you to fill your prescriptions at TRICARE retail network pharmacies throughout the country without having to submit a claim. You have access to a network of approximately 60,000 retail pharmacies in the United States and its territories ( American Samoa,* Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands) . Registration is not required. To find the nearest TRICARE retail network pharmacy, visit or call 1-877-363-1303 (TDD/TTY: 1-877-540-6261).

Active duty Soldiers do not pay copayments for prescriptions. However, if they receive medications through an overseas pharmacy or an out-of-network pharmacy, they may need to pay out-of-pocket for the total cost of the medication and then file a claim for reimbursement for the full amount.

Pharmacy Copayments

TRICARE Pharmacy Copayments in the United States (Including Puerto Rico, Guam, Virgin Islands, America Samoa, and the Northern Marianna Islands)

Type of Pharmacy

Uniform Formulary

Formulary Drugs

Non-Formulary Drugs
(Tier 3)*


(Tier 1)

Brand Name (Tier 2)

Military Treatment Facility (MTF) (up to a 90-day supply)



Not Available

TRICARE Pharmacy Home Delivery
(up to a 90-day supply)




Retail Network Pharmacy
(up to a 30-day supply)




Non-network Pharmacy
(up to a 30-day supply)***

TRICARE Prime options: 50% cost share applies after point-of-service (POS) deductible met***

All other beneficiaries: $33 or 20% of total cost, whichever is greater, after annual deductible is met ***

TRICARE Prime options : 50% cost share applies after POS deductible is met***

All other beneficiaries: $60 or 20% of total cost, whichever is greater, after annual deductible is met****

* Approval is required for active duty Service members (ADSMs). Non-formulary drugs may be obtained free of charge by ADSMs only if medical necessity is established. All other beneficiaries will pay the copayments listed above. Medical-necessity information should be submitted along with the prescription. For more information, visit

**Some non-formulary drugs are only covered through home delivery. Check with Express Scripts, Inc. before filling prescriptions for non-formulary drugs at a retail network pharmacy.

*** To have a 90-day supply of a prescription filled, pay the copayment for each 30-day supply.

Using Other Health Insurance (OHI): You are not eligible to use TRICARE Pharmacy Home Delivery if you have other health insurance (OHI) with a prescription plan, including a Medicare Part D prescription program, unless you meet one of the following requirements:

  • Your OHI does not include pharmacy benefits

  • The medication you need is not covered by your OHI

  • You have met your OHI's benefit cap ( i.e., you have met your benefit's maximum coverage limit)

Once you have met one of these requirements, you may submit your prescription to TRICARE Pharmacy Home Delivery. You'll need to send proof from your other plan that it isn't covered or you've met the benefit cap.

There are three ways to send new prescriptions to Express Scripts for Home Delivery. Ask your provider to write the prescription for the maximum supply allowed, which is 90 days for most drugs.


You can register online for each eligible Family member. You'll have online access to your account, and general information on health and prescription drugs.


You can call 1-877-363-1303 (TDD/TTY: 1-877-540-6261)


You can download the Mail Order Registration Form and mail it to: Express Scripts, Inc.

P.O. Box 52150
Phoenix, AZ 85072-2150 Also include:

  • Your written prescription.

If your OHI provides only medical coverage (not pharmacy coverage ), you still may be eligible to use TRICARE Pharmacy Home Delivery as your prescription benefit. For more information, call Express Scripts, Inc. at 1-877-363-1303 (TDD/TTY: 1-877-540-6261).

Having OHI does not prevent you from using TRICARE retail network pharmacies. If you have pharmacy benefits through your OHI, TRICARE becomes the second payer by law.

Note: Supplemental and discount prescription drug programs, such as Senior Friends and American Association of Retired Persons, do not count as OHI pharmacy coverage.

Additional Information

For more information, please visit the TRICARE Pharmacy Program webpage maintained by the TRICARE Management Activity:

TRICARE Pharmacy Program Handbook:

TRICARE DEERS Information:

Document Review Date: 21 January 2021