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Frequently Asked Questions

Formulary

What is a formulary?

A formulary is a drug list that helps determine your copayment for each prescription. In most cases, you'll pay a lower copayment for the drugs on the formulary. You can view formulary information under My Prescription Plan.

How do I find out if the drug I need is on the formulary, has a prescribing restriction or requires prior authorization?

Visit the TRICARE website to read the formulary and coverage requirements/limitations.

Why is a medication not included on the formulary?

Some medications are excluded from the in order to help control your overall healthcare costs.

The TRICARE website provides general formulary information. You can also get more information on a particular excluded drug by viewing the formulary and coverage requirements/limitations.

What is a non-formulary or non-preferred drug?

These are drugs that are not on your formulary. In most cases, you'll pay more for these drugs.

Why is a drug not included on my formulary?

To help control your overall healthcare costs, some types of medications may not be covered by your prescription drug benefit. Examples include drugs used for cosmetic purposes such as baldness or weight loss. You will usually pay 100% of the cost of these medications at a local pharmacy.

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