- Do I need to register for TRRx like I did for TMOP?
- All TRICARE-eligible beneficiaries are automatically eligible for the TRRx benefit. There is no need for you to register for the TRRx program; however, you must make sure your personal information is current in DEERS to ensure eligibility for the benefit.
- Where can I find a list of network retail pharmacies that are included in the DoD TRRx Program?
- To find the DoD TRICARE network retail pharmacies closest to you, please use the Pharmacy Locator or call 1.866.DOD.TRRX (1.866.363.8779).
- What must I have with me in order to fill my prescription at a pharmacy?
- When you visit a pharmacy in the DoD TRRx network, you should take two things: your uniformed services ID card and your prescription.
- Are there any prescription drugs that are not covered at a TRICARE network retail pharmacy?
The most common products that are not covered include those for smoking cessation, weight loss and cosmetic purposes as well as most over-the-counter products. Some over-the-counter items that are covered include alcohol swabs, needles and syringes for home-use injectable drugs, glucose test strips, insulin and insulin syringes, lancets and spacers for inhalers.
For information on drugs covered under the DoD TRRx program, please visit the TRICARE website or call 1.866.DOD.TRRX (1.866.363.8779).
- Do some drugs have limitations or special requirements?
Yes. Some prescriptions need a prior authorization before they can be filled. Others may be limited to a certain quantity or supply of medication. To see a list of drugs that require prior authorization or have quantity limits, please visit the TRICARE website, or call 1.866.DOD.TRRX (1.866.363.8779) if you have a question about a specific drug.
- Are there exceptions to limitations or special requirements?
Yes. For instance, if your doctor prescribes a drug that exceeds the quantity limit or needs a prior authorization, ask your doctor to contact Express Scripts at 1.866.684.4488. Your doctor needs to justify that the exception to the quantity limit is medically necessary or complete the paperwork for the prior authorization.
- What's the process for getting an injectable medication that has to be administered by a doctor?
- Some injectable medications that used to be available through a retail pharmacy are now available as part of your medical benefit. Visit the TRICARE Formulary Search Tool or call 1.866.363.8779, to determine if your medication is covered under your TRRx benefit. To obtain an injectable medication not available through your TRRx benefit, please contact your TRICARE Regional Contractor.
- Can I fill my prescriptions at more than one pharmacy?
Yes. You can fill your prescription at an MTF (check availability first), the TMOP or a TRRx retail pharmacy. DoD PDTS reviews your drug history each time you get prescriptions filled at any point of service to check for drug interactions and duplicate prescriptions. Depending on the type of medication you need, you can use more than one option to fill your prescriptions.
- For the greatest savings opportunities on prescriptions you need right away (such as antibiotics), use an MTF pharmacy.
- For the greatest savings opportunities on prescriptions you take on an ongoing basis (such as drugs for high blood pressure, arthritis, asthma, etc.), use an MTF pharmacy or the TMOP service.
- How do I transfer a prescription from a pharmacy that is NOT part of the DoD TRRx network?
There are three ways to transfer your prescription:
- Take your labeled medication container from your previous pharmacy to your new TRICARE network retail pharmacy. Your new pharmacy will contact your old pharmacy to transfer your prescription.
- Call your new TRICARE network retail pharmacy and ask them to call your old pharmacy for prescription transfer information.
- Ask your doctor to contact your new TRICARE network retail pharmacy to transfer your prescription.
- What do I do for a medication obtained from an overseas location not covered by the DoD TRRx network?
TRICARE may reimburse you for your purchase of medications when you use an overseas pharmacy. You may need to submit a claim (DD Form 2642) (PDF file) for your prescription.
- If assigned overseas, please contact your overseas TSC for reimbursement rates and assistance in filing your claim. Go to the TRICARE website and click on your particular region.
- If assigned stateside, please contact your TRICARE Regional Health Contractor. To find your TRICARE Regional Health Contractor, visit the TRICARE website.
- What is my copayment when a prescription filled in a TRICARE network retail pharmacy is written for less than 30 days or more than 30 days?
Your copayments are not prorated based on the number of days prescribed. If your doctor prescribed a medication for a period of less than 30 days (such as a 10-day course of antibiotics), you pay the full copayment — that is, $3 (formulary generic), $9 (formulary brand name), or $22 (nonformulary drug). If the prescription is for more than 30 days but less than 60 days, you pay a copayment of $6 ($3x2) for a formulary generic, $18 ($9x2) for a formulary brand-name, or $44 ($22x2) for a nonformulary drug at a TRICARE network retail pharmacy.
- If I am on vacation, can I still use my DoD TRRx Program benefit?
Yes. Your DoD TRICARE Retail Pharmacy Program is available everywhere in the U.S., Puerto Rico, the U.S. Virgin Islands and Guam. The retail pharmacy benefit allows you to simply pay the required copayment at a network pharmacy while traveling, without filing a claim for reimbursement. To find a network retail pharmacy near your location, please use the Pharmacy Locator or call 1.866.DOD.TRRX (1.866.363.8779).
- What happens if my prescription reimbursement claim (DD2642) or Prior Authorization request is denied?
You may call 1.866.DOD.TRRX (1.866.363.8779) or write to the address below to inquire about the reason for the denial. You will receive a written notice of the reason your claim was denied and an explanation of your appeal rights if you choose to appeal the denial.
Write to:
Express Scripts
P.O. Box 60903
Phoenix, AZ 85082-0903
- I used to pay a $9 copay for my medication and now I have to pay $22. Why?
A $22 copayment means that your medication has been designated as nonformulary under the Uniform Formulary regulations. You may wish to consult with your doctor about formulary alternatives. Or, if your doctor feels it is medically necessary for you to receive this medication, and medical necessity is established, the medication will be provided to you at the formulary copayment ($9).
- Why was the Uniform Formulary created?
In order to provide Department of Defense (DoD) beneficiaries with a world-class pharmacy benefit, the DoD has developed the Uniform Formulary (a list of covered prescription drugs) as one way to help control the ever-increasing costs of prescription drugs. There are three things that the DoD Pharmacy & Therapeutics (P&T) committee considers when determining which drugs will become non-formulary (that is, which drugs will be covered under your benefit but at a significantly higher cost share to you):
- How well they work
- How safe they are
- How much they cost
- If one drug costs more than another, does it work better?
- In the world of prescription drugs, more expensive does not always mean you are getting a better drug. There are often generic and lower-cost brand drugs that are equally effective and more affordable. When you choose to use formulary drugs, you are not only taking medications that are proven to work, you are also saving yourself and the DoD money. This is why the Uniform Formulary is so important in the quest to ease prescription-drug costs.
- Can I still use my TRICARE Senior Pharmacy Program with my DoD TRICARE Retail Pharmacy benefit?
Yes. You can still enjoy the benefits of the TRICARE Senior Pharmacy Program and use the TRRx and TMOP programs.
- Why do I need to list my OHI coverage on the claim form (DD2642)?
- Federal law requires your OHI be the primary payer and TRICARE be the secondary payer. Your claim could be delayed, or you could be reimbursed incorrectly, if the form is not accurately completed.
- Where can I find the OHI section on the claim form?
- You can provide your OHI information in Box 11 on the back page of the form (near the middle of the page). If you need more information on how to complete Box 11, refer to point 11 at the bottom of the back page.
- What if my OHI does not have prescription benefits?
- You will still need to provide your OHI information in Box 11. However, in the space where you provide your Insurance Identification Number, you may indicate "No pharmacy coverage" beneath the number.
- Is there any way that I can get a brand-name drug instead of its generic version from my TRICARE network retail pharmacy?
- It is a DoD policy for the TRICARE Retail Pharmacy (TRRx) Program to substitute a generic drug for a brand-name drug when available unless your prescribing physician is able to justify medical necessity for the brand-name drug. Please note, this was not always enforced prior to June 1, 2004, but is now being enforced through the new prescription benefit provider, Express Scripts, per the requirements of the benefit.
Beneficiaries who wish to take a brand-name drug when a generic is available must choose from the following options:- Pay 100% of the cost of the drug at the pharmacy.
- Ask the doctor to contact Express Scripts' TRRx Prior Authorization department by phone at 1.866.684.4488 or fax at 1.866.684.4477. The doctor will need to justify why it is medically necessary to receive the brand-name drug instead of the generic version. The prior authorization must be approved and entered into Express Scripts' system for you to receive the brand-name medication at the appropriate copayment. You will not be able to submit claims purchased before the effective date of the prior authorization for additional reimbursement.
- Do I need prior authorization for drugs to treat erectile dysfunction?
- Prior authorization is no longer required for coverage of PDE-5 inhibitors (drugs to treat erectile dysfunction) such as Cialis®, Levitra® and Viagra®, if you are a male patient 50 years or older.
Note: Quantity limits apply to these types of drugs. - Is there a copayment for diabetic supplies that have a prescription?
Yes. If you have a prescription for diabetic supplies that are covered under the DoD TRRx program, you will have a copayment.* If you purchased your supplies without a prescription, your claim should be forwarded to the Managed Care Support Contractor (MCSC) in your region.
Here are some examples of what you will pay for diabetic supplies (if you have a prescription):
- For insulin syringes, lancets and blood glucose strips you will pay a brand-name drug copayment ($9) for up to a 30-day supply if you use a TRRx network pharmacy.
- The copayment for alcohol swabs is $3 for up to a 30-day supply at a TRRx network pharmacy.
- If you use a non-network pharmacy, your copayment will be 20% or $9, whichever is greater.
Please contact your MCSC for information on how to obtain blood glucose meters (glucometers).
*Copayment amounts apply to all TRICARE beneficiaries except active duty service members, who have no copayments.
- I recently became eligible for the DoD TRICARE Retail Pharmacy (TRRx) Program. When will I receive my benefit guide?
Benefit guides are mailed to new military service members and new TRICARE Prime enrollees on a quarterly basis. Each of these families receives one guide. You can also print a benefit guide (PDF file) using this website.
- Didn't find your answer?
For more information about the TRICARE Pharmacy Benefit, visit the TRICARE website.
PDF files require Adobe Acrobat Reader.
