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Want to know more about your prescription drug coverage? the TRICARE Pharmacy Program Manual can help you get the most out of your pharmacy benefit. This is a useful resource for finding out how your health insurance works and what it covers.
“The TRICARE Pharmacy Program Manual has everything you need to know, from explaining your eligibility to exploring your pharmacy options,” said Robert Agnello, deputy chief of digital communications at the Defense Health Agency. “Learning how your drug benefits work can help you get the quality care you need.”
Here is an overview of the information you can find in this pharmaceutical resource.
1. Are you eligible to use TRICARE Pharmaceutical Benefits?
The TRICARE Pharmacy Program is administered by Express Scripts. It is available to eligible military members, retirees, and family members. As indicated in the manual, you must be registered with the Defense Enrollment Eligibility Reporting System (DEER). And it’s important to keep the information in DEERS up to date for you and your family members. Failure to maintain the accuracy of your information in DEERS could affect your eligibility for TRICARE, including your drug benefits.
If you are on the US Family Health Plan (USFHP), however, you are not eligible for the TRICARE Pharmacy Program. This means that you must use USFHP pharmacy suppliers. For all other TRICARE health plans, including TRICARE For Life, you can use the TRICARE Pharmacy Advantage. See the “Getting Started” section of the manual for more information.
2. What are your options for filling your prescription?
TRICARE offers you several pharmacy options. The manual includes information on these four pharmacy options:
Which pharmacy option is best for you to fill your prescription? It depends on the type of drug you need and where you live. Keep in mind that some medications need to be filled in a certain way. And the quantity limits and disbursements for your medication may also vary by pharmacy type.
3. What types of drugs are covered?
TRICARE does not cover certain medications for various reasons. Prescription drugs that TRICARE does not cover are included in the category of drugs not covered. As for the drugs covered, the manual breaks down three types:
TRICARE bases this grouping on the medical cost and effectiveness of a drug compared to other drugs of the same type. Did you know that the TRICARE formulary includes a list of prescription drugs covered by TRICARE? TRICARE reviews and updates this list quarterly.
As mentioned in the manual, you can also use the TRICARE form search tool to find out more about your prescriptions. For example, find out if your prescription drug requires prior authorization. For more information, see the “Covered Services, Limitations and Exclusions” section of the manual.
There are more parts to Pharmacy Allowance to help you manage your prescriptions than this manual can help you with. Take a moment to also browse other TRICARE resources like the Overview of the TRICARE Pharmacy Program. Don’t forget to take the post feedback survey and share your thoughts on how we can improve our posts.
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