New copayments for prescription drugs covered by TRICARE went into effect February 1, 2015. The Fiscal Year 2015 National Defense Authorization Act (NDAA) requires TRICARE to increase most pharmacy copays by $3. Drugs from military pharmacies and generic drugs from TRICARE Pharmacy Home Delivery still cost beneficiaries $0.
TRICARE pharmacy copays vary based on the class of drug and where beneficiaries choose to fill their prescriptions:
- TRICARE Pharmacy Home Delivery copays for formulary brand name drugs are going from $13 to $16, and for non-formulary from $43 to $46. Beneficiaries can get up to a 90-day supply of drugs through Home Delivery.
- At the retail pharmacy network, copays for generic formulary drugs go from $5 to $8, brand name formulary go from $17 to $20 and non-formulary from $44 to $47. Beneficiaries can get up to a 30-day supply of drugs at retail pharmacies.
Some pharmacy copays are not changing in 2015. Military pharmacies remain the lowest cost option for beneficiaries, with no cost for drugs, and generic formulary medications at Home Delivery remain $0. Home Delivery is a low-cost, safe and convenient way for TRICARE beneficiaries to get their maintenance medications. Copays at non-network retail pharmacies will also change, based on the changes to retail copays.
For more details, visit the TRICARE pharmacy costs page.
These changes in the NDAA overrule previous rules passed by Congress in 2013 that connected TRICARE pharmacy copays to the retiree cost of living adjustment (COLA).