Express Scripts TRICARE: Complete Guide to Your Pharmacy Benefit

Express Scripts TRICARE: Complete 2026 Guide to Your Military Pharmacy Benefit

Express Scripts administers the TRICARE pharmacy benefit for over 9 million beneficiaries. It manages TRICARE Pharmacy Home Delivery, the retail network of 41,000+ pharmacies, and specialty medications through Accredo. Covered prescriptions are $0 at military pharmacies. Home delivery copays range from $14 to $85 for a 90-day supply, depending on formulary tier.

Quick Facts

What Is Express Scripts TRICARE?

Express Scripts is the pharmacy benefit manager (PBM) that administers the TRICARE Pharmacy Program on behalf of the Defense Health Agency. It handles retail network management, home delivery operations, specialty pharmacy services, and formulary support for more than 9 million TRICARE beneficiaries. 

TRICARE is the health care program for uniformed service members, retirees, and their families. The pharmacy benefit is one component of TRICARE, covering outpatient prescription drugs through four pharmacy options: military pharmacies, TRICARE Pharmacy Home Delivery, retail network pharmacies, and non-network pharmacies. 

Express Scripts has held the exclusive TRICARE pharmacy contract for 23 years. The current eight-year contract, awarded in 2021, is valued at up to $4.3 billion in revenues. 

Why it matters: Without Express Scripts, TRICARE beneficiaries would have no centralized system for retail pharmacy access or mail-order prescriptions. The company’s role is administrative — the Department of Defense controls the formulary and retains negotiated savings. 

What beneficiaries should do next: Register for an Express Scripts online account at militaryrx.express-scripts.com to manage prescriptions, check coverage, and schedule home delivery. 

TRICARE Pharmacy Options: How They Compare

TRICARE has four pharmacy options. Each has different costs, supply limits, and convenience levels. 

Source: TRICARE Pharmacy Program overview. 

Military Pharmacies

Military pharmacies offer the lowest cost — $0 copay for most medications. You can get up to a 90-day supply of most drugs at no cost. Active duty service members pay nothing at military pharmacies, retail network pharmacies, or home delivery. 

Limitation: Military pharmacies are located on installations and may not stock all medications. Not all beneficiaries live near one.

TRICARE Pharmacy Home Delivery

Home delivery through Express Scripts is generally the least expensive option after military pharmacies. You can receive up to a 90-day supply with free standard shipping. Active duty service members pay nothing for home delivery. 

Key detail: Starting January 1, 2023, beneficiaries must approve each refill before Express Scripts ships the medication. This prevents automatic shipments of medications you no longer need. 

Retail Network Pharmacies

TRICARE’s retail network includes more than 41,000 locations in the U.S. and U.S. territories. You present your prescription and Uniformed Services ID card at the pharmacy counter. No claim submission is required. 

Important exclusion: Walmart and Sam’s Club pharmacies are not part of the TRICARE retail network. Filling prescriptions there results in non-network copayments. 

Non-Network Pharmacies

Non-network pharmacies are outside TRICARE’s contracted network. You may have to pay the full cost upfront and file a claim for reimbursement. Reimbursements are subject to deductibles and out-of-network cost shares. 

When to use: Emergency situations, travel, or when no network pharmacy is available.

2026 TRICARE Pharmacy Copayments

TRICARE copayments changed on January 1, 2026. The increases reflect a 12% to 15.8% rise over 2025 rates for retail and mail-order medications. 

2026 Copayment Chart

Source: Express Scripts 2026 copayment announcement. 

Major Copay Change: TRICARE Prime Remote

Effective February 28, 2026, active duty family members enrolled in TRICARE Prime Remote in the U.S. have no copayments for covered drugs filled through home delivery or retail network pharmacies. This waiver applies automatically — no action needed. 

Exclusions: The waiver does not apply overseas. Non-formulary drugs require medical necessity approval from Express Scripts. Maintenance drugs still must be refilled through home delivery after two retail fills. 

Who Is Exempt from 2026 Copay Increases

Copayments remain unchanged for:

• Active duty service members ($0 for covered drugs)

• Dependent survivors of active duty service members

• Medically retired service members and their dependents 

TRICARE Formulary: How Drug Tiers Work

The TRICARE formulary is a list of brand-name and generic drugs covered by the program. It is maintained by the Department of Defense, not Express Scripts. 

Three Formulary Tiers

Mandatory generic policy: TRICARE requires prescriptions to be filled with a generic product if one is available. Generic drugs must undergo FDA testing and are considered safe alternatives to brand-name drugs. 

How to check your drug: Use the TRICARE Formulary Search Tool at express-scripts.com/tform or through your Express Scripts online account. The tool shows coverage, copays, prior authorization requirements, and alternative options. 

Prior Authorization and Medical Necessity

Some TRICARE medications require prior authorization (PA) or medical necessity (MN) approval before coverage is granted. Express Scripts reviews these requests. 

When Prior Authorization Is Required

• Brand-name drugs when a generic is available

• Non-formulary drugs

• Medications with quantity limits or coverage restrictions

• Compound drugs that fail electronic screening 

How to Request Prior Authorization

1. Download the form. The TRICARE Prior Authorization Request Form is available on Express Scripts’ website or through the Formulary Search Tool.

2. Give it to your doctor. The prescriber completes and submits the form to Express Scripts.

3. Wait for review. Standard review takes about five days from receipt of all paperwork. 

Checking Prior Authorization Status

Log in to your Express Scripts account. Under Prescriptions, select Prior Authorizations. All PAs from the past 18 months display with their status. You can also view them in the Express Scripts Pharmacy mobile app. 

If Prior Authorization Is Denied

You have 90 days to request a formal appeal. The appeals process is handled through TRICARE, not Express Scripts directly. 

TRICARE Pharmacy Eligibility

All TRICARE-eligible beneficiaries registered in the Defense Enrollment Eligibility Reporting System (DEERS) are automatically eligible for the retail network pharmacy option. Registration is not required for retail. 

Who Qualifies

Source: MyArmyBenefits TRICARE Pharmacy fact sheet. 

Medicare Part B Requirement

Beneficiaries who turned 65 on or after April 1, 2001 must be enrolled in Medicare Part B and have their DEERS profile updated to participate in TRICARE Pharmacy. Those who turned 65 before that date may participate without Part B. 

How to Use TRICARE Home Delivery

Home delivery is the most cost-effective option for maintenance medications. Express Scripts ships medications directly to your door.

Getting Started

1. Register for an Express Scripts account. Visit militaryrx.express-scripts.com and select Register. You will need your DoD Benefits Number (DBN) or Social Security Number to verify your identity. 

2. Ask your doctor to send a 90-day prescription. Home delivery accepts up to a 90-day supply of most medications. 

3. Transfer existing prescriptions. Use your online account, the Express Scripts Pharmacy mobile app, or call (877) 363-1303. 

4. Approve each refill. Since January 2023, you must approve each refill before shipment to avoid receiving medications you no longer need. 

5. Track your order. Express Scripts sends status updates via phone, email, and text. 

Specialty Medications

Certain specialty medications for complex and chronic conditions are filled through Accredo, Express Scripts’ specialty pharmacy. Accredo provides expanded clinical support and can be reached at (877) 882-3324. 

Express Scripts Mobile App

The Express Scripts Pharmacy mobile app lets TRICARE beneficiaries manage prescriptions from a smartphone. The app is free on the Apple App Store and Google Play Store. 

App Features

• Locate TRICARE retail network pharmacies

• Order prescriptions and request refills

• Track order status

• Check coverage and compare prices

• View prior authorizations

• Contact pharmacists 24/7 

Registration required: You must register on the Express Scripts website before using the mobile app. 

Common Mistakes TRICARE Beneficiaries Make

1. Filling prescriptions at Walmart or Sam’s Club. These pharmacies are not in the TRICARE network. You will pay non-network copayments. Use the Find a Pharmacy tool to locate a network pharmacy. 

2. Not registering for home delivery for maintenance drugs. Home delivery offers 90-day supplies at lower copays than retail. Maintenance drugs must be refilled through home delivery after two retail fills. 

3. Ignoring refill approval requests. Since 2023, Express Scripts requires approval for each refill. Unapproved refills are not shipped. 

4. Assuming all drugs are covered. Non-covered drugs (Tier 4) are not reimbursed. Check the Formulary Search Tool before filling. 

5. Forgetting to update DEERS. DEERS must reflect current address and family information for home delivery to work correctly. 

6. Not checking for prior authorization requirements. Filling a drug that requires PA without approval may result in full out-of-pocket costs. 

7. Paying upfront at non-network pharmacies without filing a claim. Reimbursement is not automatic. You must file a claim. 

8. Missing the 90-day appeal window. If a prior authorization is denied, you have 90 days to request a formal appeal. 

Common Questions

1. What is Express Scripts TRICARE?

Express Scripts is the pharmacy benefit manager that administers the TRICARE Pharmacy Program for the Defense Health Agency. It manages the retail pharmacy network, home delivery operations, specialty pharmacy services, and formulary support for over 9 million beneficiaries. 

2. What are the 2026 TRICARE pharmacy copays?

Military pharmacies charge $0. Home delivery costs $14 for generics, $44 for brand-name, and $85 for non-formulary (90-day supply). Retail network costs $16, $48, and $85 respectively (30-day supply). 

3. How do I register for TRICARE home delivery?

Visit militaryrx.express-scripts.com and select Register. You will need your DoD Benefits Number or Social Security Number. Once registered, ask your doctor to send a 90-day prescription or transfer existing prescriptions online. 

4. Does Walmart accept TRICARE?

No. Walmart and Sam’s Club pharmacies are not part of the TRICARE retail network. Filling prescriptions there results in non-network copayments. Use the Find a Pharmacy tool to locate a network pharmacy. 

5. What is the Express Scripts phone number for TRICARE?

Call 877-363-1303 for general TRICARE pharmacy questions. TDD/TTY users can call 877-540-6261. For specialty medications through Accredo, call 877-882-3324. 

6. Who is eligible for TRICARE pharmacy benefits?

Active duty service members, retirees, National Guard and Reserve members on federal active duty, and their family members are eligible. All must be registered in DEERS. 

7. What is the TRICARE formulary?

The TRICARE formulary is a list of covered prescription drugs maintained by the Department of Defense. Drugs are classified into three tiers: generic formulary (Tier 1), brand-name formulary (Tier 2), and non-formulary (Tier 3). 

8. How do I check if my medication is covered?

Use the TRICARE Formulary Search Tool at express-scripts.com/tform or through your Express Scripts online account. The tool shows coverage, copays, prior authorization requirements, and alternative options. 

9. What is prior authorization and when is it needed?

Prior authorization is approval required before TRICARE covers certain medications, including brand-name drugs when generics are available, non-formulary drugs, and drugs with coverage limitations. Express Scripts reviews these requests. 

10. What changed with TRICARE pharmacy copays in 2026?

Copays increased on January 1, 2026. Home delivery generics rose from $13 to $14; brand-name from $38 to $44; non-formulary from $76 to $85. Retail network brand-name rose from $43 to $48. 

11. Can I get a 90-day supply at a retail pharmacy?

No. Retail network pharmacies dispense up to a 30-day supply. For 90-day supplies, use home delivery or a military pharmacy. 

12. Is there an Express Scripts mobile app for TRICARE?

Yes. The free Express Scripts Pharmacy mobile app lets you manage prescriptions, track orders, check coverage, and locate network pharmacies. You must register on the Express Scripts website before using the app. 

Key Takeaways

• Express Scripts administers the TRICARE pharmacy benefit for over 9 million beneficiaries under an exclusive contract with the Defense Health Agency.

• Four pharmacy options: military pharmacies ($0), home delivery, retail network, and non-network pharmacies.

• 2026 copays: Home delivery — $14 generic, $44 brand-name, $85 non-formulary (90-day). Retail network — $16, $48, $85 (30-day).

• TRICARE Prime Remote waiver: Active duty family members in the U.S. have $0 copays for covered drugs at retail network and home delivery as of February 28, 2026.

• Walmart and Sam’s Club are not in the network. Filling there results in non-network copayments.

• Home delivery is the least expensive option after military pharmacies. Up to 90-day supplies with free shipping.

• Prior authorization is required for certain brand-name, non-formulary, and compound drugs. Express Scripts reviews these requests.

• Register at militaryrx.express-scripts.com to manage prescriptions, check coverage, and use the mobile app.

• Specialty medications are filled through Accredo, Express Scripts’ specialty pharmacy.

• DEERS registration is required for all TRICARE pharmacy eligibility.

Official Resources

• TRICARE Pharmacy Program: tricare.mil/pharmacy

• Express Scripts TRICARE: militaryrx.express-scripts.com

• TRICARE Formulary Search Tool: express-scripts.com/tform

• TRICARE Pharmacy Costs: tricare.mil/Costs/PharmacyCosts

• Defense Health Agency: health.mil

• DEERS Registration: milconnect.dmdc.osd.mil

• Medicare Part B Enrollment: Medicare.gov

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