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Prescription drugs may be covered under the pharmacy benefit or the medical benefit. After each review, some drugs may move from one category to another. Your costs will vary depending on your drug category. Prescription drugs fall into four categories:. These categories follow industry standards. They depend on the medical effectiveness and cost effectiveness of a drug compared to other similar drugs. Certain prescriptions require a pre-authorization. You may need pre-authorization for your prescription if it:.

Exceptions can be made if your provider establishes medical necessity. Express Scripts Website. Compound Drugs. Home Infusion Therapy. Infusion and Injectable Medications. Over-the-Counter Drugs and Supplies. Pharmacy Benefits and Medicare.

Specialty Drugs. Step Therapy. Health Plans. Compare Plans. Enroll or Purchase a Plan. Using Other Health Insurance. Dental Plans. Special Programs. Find a Doctor. Provider Types. All Provider Directories. Find a Military Hospital or Clinic.

Book Appointments. Getting Care When on Active Duty. Getting Care When Traveling. Types of Military Facilities. What's Covered. Health Care. Dental Care. Prescription Drugs. Generic and Brand-Name Formulary Drugs. Non-Formulary Drugs. Non-Covered Drugs. Filling Prescriptions. Manage My Prescriptions. Pharmacy Claims.

Pharmacy Appeals. Mental Health Care. Reproductive Health. Special Needs. Benefit Updates. How a Benefit Becomes Covered. Health Plan Costs. Cost Terms. Dental Costs. Pay My Bill. Life Events. Qualifying Life Events. Separating from Active Duty. Giving Birth or Adopting. Getting Married. Getting a Divorce or Annulment. Becoming Medicare-Eligible. Going to College. Children Becoming Adults. Losing or Gaining Other Health Insurance. Death in the Family. Moving When Deploying. Injured on Active Duty.

Filing Claims. Download a Form. Contact Us. Call Us. Find My Login. Find a Claims Address. Ask a Benefit Question. File a Complaint. Report Fraud and Abuse. Health and Wellness. Healthy Living. Substance Abuse. Brain Injury Awareness. Mental Health Awareness. Pain Management. Public Health. Preventive Services. Fact Sheets. Wallet Card. Go Paperless. My Military Health Records. Multimedia Center. Recoupment of Overpayments. Rights and Responsibilities. About Us. News Center. Facts and Figures.

For Providers. For Staff. For Members of the Media. For Vendors. Covered Services Learn more about what we cover - including health, dental, and pharmacy. Prescription drugs fall into four categories: Generic formulary drugs Brand-name formulary drugs Non-formulary drugs Non-covered drugs These categories follow industry standards.

Pre-authorization Requirements Certain prescriptions require a pre-authorization. Find a Phone Number.

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Find a Military Hospital or Clinic. Book Appointments. Getting Care When on Active Duty. Getting Care When Traveling. Types of Military Facilities. What's Covered. Health Care.

Dental Care. Prescription Drugs. Generic and Brand-Name Formulary Drugs. Non-Formulary Drugs. Non-Covered Drugs. Filling Prescriptions. Manage My Prescriptions. Pharmacy Claims. Pharmacy Appeals. Mental Health Care. Reproductive Health. Special Needs. Benefit Updates. How a Benefit Becomes Covered. Health Plan Costs. Cost Terms. Dental Costs. Pay My Bill. Life Events.

Qualifying Life Events. Separating from Active Duty. Giving Birth or Adopting. Getting Married. Getting a Divorce or Annulment. Becoming Medicare-Eligible. Going to College.

Children Becoming Adults. Losing or Gaining Other Health Insurance. Death in the Family. Moving When Deploying. Injured on Active Duty. Filing Claims. Download a Form. Contact Us. Call Us. Find My Login. Find a Claims Address. Ask a Benefit Question. File a Complaint. Report Fraud and Abuse. Health and Wellness. Healthy Living. Substance Abuse. Brain Injury Awareness. Seeking Clinical Mental Health Services? These services can help you get care so you can stay balanced, in both mind and body.

If so, you may qualify for extra benefits. You might feel frustrated or confused during this time. Preparing for open season now can help you make the best selection for you and your family later. Register for September 29 Webinar.

Are you planning to have a child? An official website of the United States government Here's how you know. Official websites use. Department of Defense organization in the United States. Share sensitive information only on official, secure websites. Skip to main content Press Enter. News June 22, For you, that could be blood pressure medication. For a family member, it could be medication to treat an allergy. Public Health Service Cmdr. You can search for a wide range of prescription drugs.

These are substitutes for brand-name drugs. You can find them in most pharmacies and they cost less than the other options below. Brand-name formulary drugs. Non-formulary drugs. These drugs will usually have higher cost-shares than generic and brand-name drugs, unless your provider can establish medical necessity. Non-covered drugs. Found your covered prescription with the search tool?

It offers accessible and affordable prescription drugs for you and your family. Take a minute to see how getting your prescription drugs delivered may be right for you. It also supports your individual and family readiness. Seeking Clinical Mental Health Services? These services can help you get care so you can stay balanced, in both mind and body. If so, you may qualify for extra benefits. You might feel frustrated or confused during this time. Preparing for open season now can help you make the best selection for you and your family later.

Register for September 29 Webinar. Are you planning to have a child? An official website of the United States government Here's how you know. Official websites use. Department of Defense organization in the United States. Share sensitive information only on official, secure websites.

Skip to main content Press Enter. News June 22, For you, that could be blood pressure medication. For a family member, it could be medication to treat an allergy. Public Health Service Cmdr. You can search for a wide range of prescription drugs. These are substitutes for brand-name drugs.

You can find them in most pharmacies and they cost less than the other options below. Brand-name formulary drugs.

Non-formulary drugs. These drugs will usually have higher cost-shares than generic and brand-name drugs, unless your provider can establish medical necessity. Non-covered drugs. Found your covered prescription with the search tool? Keep in mind, some drugs may only be filled using a certain pharmacy option.

Each option is available worldwide, but there may be some limitations overseas. The search tool can help you learn more about specific costs for each type of drug. Got more questions? Be sure to contact the pharmacy contractor, Express Scriptswho can answer questions you may have about your prescription drug coverage. Read More. A woman holds her baby while working on a laptop.

Want your prescriptions delivered to your front door? Nurse practitioner talks to patient. Two service members greet each other. Learn W If left untreated, mental health difficulties could affect your physical health. A woman shows off her smile. Have you or a family member been diagnosed with a chronic medical condition? If so, you may qualify for extra Signing divorce papers. The divorce process can create intense emotions. You might feel frustrated or confused during this time A woman standing in the street.

This open season is for dental and Woman browses her computer while holding a cup. Search Articles by Keyword.

To view pricing and coverage information, log in and go to Price a Medication under Prescriptions in the main menu. Select a member of your plan. Express Scripts Medicare will generally cover a drug as long as the drug is medically necessary, the prescription is filled at an Express Scripts Medicare. Express Scripts Medicare will cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at an Express. Express Scripts Medicare will generally cover a drug as long as the drug is medically necessary, the prescription is filled at an Express Scripts Medicare. discusses TRICARE's coverage of prescription drugs, You'll get a letter from Express Scripts if you have a prescription for a formulary. Mental Health Awareness. A woman holds her baby while working on a laptop. About Us. For you, that could be blood pressure medication. After each review, some drugs may move from one category to another.

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