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Tricare Formulary Search Tool: How to Find Your Prescription Medications

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SMART WORLD - Tricare Formulary Search Tool - As a military service member or family member, you have access to Tricare, a comprehensive healthcare program that provides coverage for medical and pharmacy services. However, navigating the Tricare pharmacy program can be confusing, especially when it comes to finding your prescription medications.

Tricare provides a Formulary Search Tool to assist in locating medications and comprehending coverage under the Tricare pharmacy program. This article will offer guidance on using the tool and maximizing your Tricare prescription coverage by providing all necessary information.

Tricare Formulary Search Tool: A Quick Overview

The Tricare Formulary Search Tool is an online database that lists all prescription medications covered under the Tricare pharmacy program. The formulary is updated regularly and includes both generic and brand-name drugs, as well as specialty medications.

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Using the Tricare Formulary Search Tool is simple. You can search for your medication by entering its name or the first few letters of its name in the search bar. You can also browse the formulary by clicking on the alphabet letters or drug categories listed on the tool.

Once you find your medication, you can see its coverage status, which tier it falls under, and any applicable copayments. You can also see any restrictions or limitations on the medication, such as quantity limits or prior authorization requirements.

Understanding Tricare Pharmacy Benefits

Before we dive into how to use the Tricare Formulary Search Tool, let's first review some basics of the Tricare pharmacy program.

Tricare offers several pharmacy options, including military treatment facility (MTF) pharmacies, Tricare retail network pharmacies, Tricare Mail Order Pharmacy, and Tricare specialty pharmacies. Depending on your location, medical needs, and prescription medications, you may use one or more of these pharmacy options.

Tricare pharmacy benefits are divided into three tiers, each with different copayments:

  • Tier 1: Generic prescription medications with the lowest copayments.
  • Tier 2: Brand-name prescription medications with higher copayments than Tier 1.
  • Tier 3: Non-formulary prescription medications with the highest copayments.

To receive Tricare prescription coverage, you must have a valid prescription from a licensed healthcare provider. You may also need to meet certain criteria for coverage, such as prior authorization or medical necessity.

Using the Tricare Formulary Search Tool

Now that you understand the basics of the Tricare pharmacy program, let's walk through how to use the Tricare Formulary Search Tool.

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Step 1: Access the Tool

The Tricare Formulary Search Tool is available on the Tricare website. To access the tool, go to www.tricare.mil/CoveredServices/Pharmacy/FormularySearch and select your Tricare plan from the dropdown menu.

Step 2: Search for Your Medication

Once you access the tool, you can search for your medication by entering its name or the first few letters of its name in the search bar. You can also browse the formulary by clicking on the alphabet letters or drug categories listed on the tool.

Step 3: Review Medication Coverage and Information

Once you find your medication, you can see its coverage status, which tier it falls under, and any applicable copayments. You can also see any restrictions or limitations on the medication, such as quantity limits or prior authorization requirements.

If your medication is not listed in the formulary, it may not be covered under the Tricare pharmacy program. However, you can work with your healthcare provider to find alternative medication options that are covered by Tricare.

Step 4: Locate a Tricare Network Pharmacy

Once you know which medication you need, you can locate a Tricare network pharmacy that carries it. Tricare retail network pharmacies are the most common pharmacy option, and there are over 58,000 participating pharmacies nationwide.

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To find a Tricare network pharmacy near you, go to the Tricare website and use the Find a Doctor, Hospital or Pharmacy tool. You can search for pharmacies by location, pharmacy name, or pharmacy type. You can also filter your search results by specific pharmacy services, such as 24-hour pharmacies or pharmacies with drive-thru services.

If you prefer to have your medications delivered directly to your door, you may consider using the Tricare Mail Order Pharmacy. This option allows you to order up to a 90-day supply of your medication and have it delivered to your home. You can also order refills online, by phone, or by mail.

Conclusion

Navigating the Tricare pharmacy program can be overwhelming, but with the Tricare Formulary Search Tool, you can easily find your prescription medications and understand their coverage under the program. Remember to always have a valid prescription from a licensed healthcare provider and to use a Tricare network pharmacy to receive the most affordable copayments.

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