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Do you get prescription drugs through the TRICARE Pharmacy Program? You may have new copayments starting Jan. 1, 2026.
The National Defense Authorization Act for Fiscal Year 2018 established TRICARE prescription drug costs. The costs will be in effect through Dec. 31, 2027.
“Most beneficiaries will pay $1 to $9 more per copayment for covered drugs they get through TRICARE Pharmacy Home Delivery and TRICARE retail network pharmacies,” said U.S. Public Health Service Cmdr. Teisha Robertson, chief of the Pharmacy Benefit Integration Branch at the Defense Health Agency. “The cost of generic formulary drugs at retail network pharmacies will stay the same.”
A few things affect your costs, as noted in the TRICARE Pharmacy Program Overview Fact Sheet.
1. Your beneficiary category:
• Active duty service members: You’ll pay nothing for covered drugs from military pharmacies, home delivery, and retail network pharmacies.
• Survivors of ADSMs and medically retired service members and their family members: Your copayments won’t change in 2026. Go to Pharmacy Costs to learn more.
• All other beneficiaries: Most copayments will increase in 2026.
2. Your drug’s category
TRICARE groups prescription drugs into four categories:
• Generic formulary drugs
• Brand-name formulary drugs
• Non-formulary drugs
• Non-covered drugs
There are a few things you should know about drug categories:
• Generic formulary drugs are the least expensive. This is followed by brand-name formulary drugs and non-formulary drugs.
• You can get a non-formulary drug at the formulary cost if your provider establishes medical necessity and the medical necessity authorization request is approved.
• If you fill a prescription for a non-covered drug, you’ll pay the full cost of the drug.
Not sure which category your drug is in? You can search the TRICARE Formulary to check. (Keep in mind that the search tool won’t show next year’s copayments until Jan. 1.)
3. The type of pharmacy you use
Where you get your prescription also affects your costs.
TRICARE pharmacy costs (2026–2027)
See the new copayments (in bold) below.
Military pharmacies (up to a 90-day supply)
• You’ll pay nothing. (Call the pharmacy to confirm they carry your drug.)
Home delivery (up to a 90-day supply)
• Generic formulary drugs will increase from $13 to $14.
• Brand-name formulary drugs will increase from $38 to $44.
• Non-formulary drugs will increase from $76 to $85.
Retail network pharmacies (up to a 30-day supply)
• Generic formulary drugs will still be $16.
• Brand-name formulary drugs will increase from $43 to $48.
• Non-formulary drugs will increase from $76 to $85.
Non-network pharmacies (Up to a 30-day supply)
Your TRICARE health plan determines your non-network pharmacy costs in the U.S. and U.S. territories. (Note: Go to Pharmacy Costs to find cost-shares for overseas pharmacies.)
Do you have a TRICARE Prime plan? If so, your non-network pharmacy costs will stay the same. With a TRICARE Prime plan:
• You must meet your point-of-service deductible for covered drugs.
• You’ll pay a 50% cost-share for covered drugs after you meet this deductible.
Do you have another TRICARE plan? You’ll pay a copayment or cost-share after you meet your annual deductible. These costs are:
• Generic and brand-name formulary drugs will cost $48 (up from $43) or 20% of the total cost, whichever is more.
• Non-formulary drugs will cost $85 (up from $76) or 20% of the total cost, whichever is more.
Keep in mind that if you use a non-network pharmacy, you’ll have to pay full price for your drug up front. Then you can file a claim for reimbursement. Reimbursements are subject to applicable deductibles, cost-shares, and copayments.
Do you have questions about copayment changes? Call the TRICARE Pharmacy contractor, Express Scripts, at 877-363-1303.
Want to learn more about your pharmacy benefit? Go to TRICARE Pharmacy.
| Date Taken: | 11.13.2025 |
| Date Posted: | 11.13.2025 11:44 |
| Story ID: | 550993 |
| Location: | FALLS CHURCH, VIRGINIA, US |
| Web Views: | 52 |
| Downloads: | 1 |
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