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What you need to know about new TRICARE pharmacy network options

As of Dec. 15, CVS Pharmacy is a part of the TRICARE retail pharmacy network. At the same time, Walmart, Sam’s Club, and some community pharmacies are no longer a part of the TRICARE network. What does this mean for you? Although the list of retail network pharmacies has changed, you can still get the medications you need.

“We understand that change is rarely easy,” said U.S. Public Health Service Cmdr. Teisha Robertson, a pharmacist with the Defense Health Agency’s Pharmacy Operations Division. “However, we remain committed to providing you with the highest number of convenient nearby in-network options for filling your prescriptions.”

To help you navigate your TRICARE pharmacy network options, take a look at the Q&A below.

Q: How do I know if these changes affect my pharmacy?
A: If you currently use a Walmart or Sam’s Club pharmacy to fill your prescriptions, you should move your prescription to a network pharmacy. After Dec. 15, if you fill a prescription at a Walmart or Sam’s Club pharmacy, you’ll have to pay the full cost of your prescription up front. As detailed in the TRICARE Pharmacy Program Handbook, you can file a claim for partial reimbursement of the cost of your medication after you’ve met your deductible at a non-network pharmacy. Check out Filling Prescriptions to learn more.

If you use a community pharmacy, these changes may also affect you. Three thousand community pharmacies also left the network. However, more than 14,000 other community pharmacies are still in the network. Are you unsure whether these changes affect your local pharmacy? You can contact them to confirm they’re still in the TRICARE network before getting your prescription filled.

Q: How do I find a new pharmacy?
A: Express Scripts, the TRICARE pharmacy contractor, sent out letters and emails to all beneficiaries directly impacted by these changes. These messages provided a list of pharmacies near you. You can also use the online Find a Pharmacy tool to locate a new network pharmacy in your area. Starting today, the pharmacy search tool will reflect the new pharmacy network to include CVS pharmacies. Choose the pharmacy option that works best for you.

Q: How do I transfer my prescription to another pharmacy?
A: To transfer your prescription to the pharmacy of your choice, you have several options. You can:

  • Call your new pharmacy to transfer your prescription.
  • Bring your prescription label to your new pharmacy.
  • Bring your prescription label to your local military pharmacy for transfer to their system.
  • Ask your doctor to write a new prescription and then send it electronically to the new military pharmacy.
  • Ask your doctor to call the new pharmacy with your new prescription.
  • Ask your doctor to send a prescription electronically to TRICARE Pharmacy Home Delivery.
  • Log in or register on the Express Scripts website to move eligible prescriptions to home delivery.
  • Call Express Scripts at 1-877-363-1303. Choose option 3 to move your eligible prescription to home delivery.

Keep in mind that both home delivery and military pharmacies are lower cost options than retail pharmacies. If you take medications on a regular basis, you may want to think about switching to home delivery. With home delivery, you can get up to a 90-day supply of your medications.

Q: What about special or limited distribution medication?
A: Express Scripts added Accredo to the TRICARE network. Accredo is a specialty pharmacy. If you have a complex or chronic condition, this is an option for you. You can call 1-877-882-3324 to learn more about using Accredo to fill your specialty medication.

Q: Why are my pharmacy copayments increasing in 2022?
A: Pharmacy copayments will increase on Jan. 1. However, the increase isn’t related to these network pharmacy changes. Congress set the TRICARE pharmacy copayments several years ago. Your copayments last changed in 2020.

Do you have more questions about your pharmacy benefit? Visit Pharmacy on the TRICARE website to learn more. Express Scripts is also available 24/7. You can call 1-877-363-1303 to get help if you have questions.

This article was released by TRICARE Military Health System.