When you’re in the military or a family member of someone who is, getting your prescriptions shouldn’t be a headache. But with TRICARE’s formulary rules, copay tiers, and ever-changing policies, it’s easy to get confused-especially when it comes to generics. The good news? TRICARE covers generics heavily, and for most people, it’s one of the most affordable prescription systems in the country. The catch? Not every generic is covered the same way, and knowing where to fill your script can save you hundreds a year.
What Counts as a Generic Under TRICARE?
A generic drug isn’t just a cheaper version of a brand-name pill. It’s the exact same active ingredient, same dosage, same way it works in your body. The FDA requires generics to meet the same safety and effectiveness standards as brand-name drugs. TRICARE recognizes this and pushes generics hard-92% of all prescriptions filled through TRICARE in 2025 were for generics. That’s higher than most civilian insurance plans. But here’s the thing: just because a drug is generic doesn’t mean TRICARE automatically covers it. The program has a formulary-a list of approved drugs. If your generic isn’t on that list, you’ll need a prior authorization. About 12% of generic drugs require this step, even if they’re FDA-approved. That’s why checking the TRICARE Formulary Search tool before your doctor writes the script is critical.The Four Tiers of TRICARE Drug Coverage
TRICARE organizes drugs into four tiers. Generics live mostly in Tier 1, the cheapest and most preferred. Here’s how it breaks down:- Tier 1: Generic Formulary Drugs - These are the backbone of TRICARE’s pharmacy program. Low cost, high effectiveness. Copays vary by where you fill them.
- Tier 2: Brand-Name Formulary Drugs - Covered, but more expensive. You’ll pay more unless no generic exists.
- Tier 3: Non-Formulary Drugs - These aren’t on the approved list. You can still get them, but only with medical necessity approval. Approval rates are around 78%.
- Tier 4: Non-Covered Drugs - Not covered at all. No exceptions. This includes certain weight loss medications as of August 31, 2025, for TRICARE For Life beneficiaries.
Where to Fill Your Prescription and How Much It Costs
Where you get your generic matters more than you think. TRICARE has three main ways to fill prescriptions, and each has a different price tag.Military Pharmacies - If you live near a military treatment facility, this is your best option. You pay $0 for any covered generic, no matter what. No copay. No deductible. Just walk in with your prescription and your ID. Over 76% of active duty members use this route.
TRICARE Home Delivery - Managed by Express Scripts, this service gives you 90-day supplies by mail. For generics, the copay is $13 through December 31, 2025. Starting January 1, 2026, it goes up to $14. That’s still cheaper than most civilian plans, where 90-day supplies of the same drug can cost $30-$50. You’ll need to sign up for home delivery through the Express Scripts portal.
Network Retail Pharmacies - CVS, Walgreens, Rite Aid, and others that are part of TRICARE’s network. For a 30-day supply of a generic, you pay $16 in 2025 and 2026. That’s a flat rate, no matter the drug. But here’s a warning: not every local pharmacy is in-network. Always check the TRICARE pharmacy locator before you go. If you go to a non-network pharmacy, you’ll pay 50% of the cost after your deductible-or 20% of the total, whichever is higher. That can quickly turn a $16 bill into a $60 one.
What’s Not Covered? The Weight Loss Drug Exclusion
One of the biggest changes in 2025 was the removal of coverage for weight loss generics like phentermine and liraglutide for TRICARE For Life beneficiaries (retirees over 65). This change, mandated by the 2024 National Defense Authorization Act, took effect August 31, 2025. It affects about 1.2 million people. The Defense Health Agency says it’s about cost control and aligning with federal guidelines. But for many retirees managing obesity-related conditions like diabetes or hypertension, this gap is real.Some beneficiaries report having to switch to over-the-counter alternatives or pay out of pocket-sometimes $100+ a month. The program doesn’t offer exceptions, even if your doctor says the drug is medically necessary. This is the only major category where TRICARE’s coverage is more restrictive than Medicare Part D, which still covers many weight loss generics.
How to Check If Your Generic Is Covered
Don’t guess. Don’t assume. Always check the TRICARE Formulary Search tool. Type in the exact drug name and strength. The tool tells you:- Which tier it’s on
- Whether it needs prior authorization
- What your copay will be at each pharmacy type
- If a therapeutic alternative is available
The tool got an update in February 2025 to show real-time cost estimates. It’s mobile-friendly, but some users still struggle with it. If you’re not sure, call the TRICARE Pharmacy Helpline at 1-877-363-1303. They handled 1.2 million calls in 2025, with average wait times under five minutes.
Common Problems and How to Fix Them
People run into the same issues over and over:- "My doctor prescribed a generic, but the pharmacy says it’s not covered." → Check the formulary. It might be non-formulary. If so, ask your provider to submit a prior authorization request. Approval takes about 48 hours on average.
- "The retail pharmacy didn’t know my copay." → Many pharmacy staff aren’t trained on TRICARE rules. Always have your TRICARE ID card handy and ask to speak to the pharmacy benefits manager.
- "I got billed $48 after filling my generic." → You probably used a non-network pharmacy. Next time, use the locator tool to find an in-network one.
- "My 90-day refill was delayed." → Home delivery can take 7-10 days. Plan ahead. Don’t wait until you’re out.
One retiree from Florida told Military.com: "I used to pay $30 for my generic statin at my local CVS. Now I get 90 days for $13 through home delivery. I saved $180 a year just by switching." That’s the kind of win TRICARE was built for.
How TRICARE Compares to Other Programs
TRICARE isn’t perfect, but it’s strong in key areas:| Program | Generic Copay (30-day) | 90-Day Option | Free at Military Pharmacy? | Formulary Flexibility |
|---|---|---|---|---|
| TRICARE | $16 (retail) | $13 (home delivery) | Yes ($0) | Moderate (12% require prior auth) |
| Medicare Part D | $7-$10 | Varies by plan | No | High (plans vary widely) |
| VA Pharmacy | $0 | $0 | Yes | High (but limited to veterans) |
| Average Employer Plan | $15-$25 | $30-$50 | No | High |
TRICARE’s biggest advantage? The $0 copay at military pharmacies. No other program offers that. Its biggest weakness? The weight loss drug exclusion and slower prior authorization turnaround compared to private insurers.
What’s Changing in 2026?
TRICARE is making a few key moves:- Home delivery copay for generics rises from $13 to $14 on January 1, 2026. Retail stays at $16.
- 17 new generics were added to the formulary in October 2025, including newer versions of diabetes and blood pressure meds.
- By Q3 2026, providers will see real-time cost and coverage info right when they prescribe-no more guessing.
- Step therapy (trying cheaper drugs first) will expand to 15 more drug classes, including some mental health and pain meds.
Experts predict TRICARE’s generic usage will hit 94% by 2030 as more brand-name drugs lose patents. That could save the program $2.3 billion a year. For beneficiaries, that means more access, not less.
Bottom Line: Save Money, Stay Informed
TRICARE’s coverage for generics is one of its strongest features. If you use military pharmacies, pay nothing. If you use home delivery, you’re still paying less than most civilians. The key is knowing your options and checking the formulary before you fill anything.Don’t let confusion cost you. Use the TRICARE Formulary Search tool. Call the helpline if you’re stuck. And if you’re on weight loss meds and over 65? Start talking to your doctor now about alternatives. TRICARE isn’t perfect-but for millions of military families, it’s the best deal they’ve got.
Are all generic drugs covered by TRICARE?
No. TRICARE has a formulary-a list of approved drugs. About 92% of prescriptions are for generics, but only those on the formulary are automatically covered. About 12% of generic drugs require prior authorization, even if they’re FDA-approved. Always check the TRICARE Formulary Search tool before filling a prescription.
What’s the copay for generic drugs at a military pharmacy?
$0. All covered generic and brand-name drugs are free at military treatment facility pharmacies for all TRICARE beneficiaries, including active duty, retirees, and their families. This is the most cost-effective option available.
Why is my generic not covered even though it’s cheaper than the brand?
TRICARE doesn’t cover every generic just because it’s cheaper. The program uses a formulary based on clinical effectiveness, cost, and therapeutic alternatives. Some generics are excluded if a better or more cost-effective option already exists on the list. You can request prior authorization, and about 78% of those requests are approved.
Can I use a non-network pharmacy for my TRICARE generics?
Yes, but it’s expensive. If you use a non-network pharmacy, you’ll pay either 50% of the cost after your deductible, or 20% of the total cost, whichever is greater. For a $50 generic, that could mean paying $10 or more. Always use the TRICARE pharmacy locator to find in-network options.
Are weight loss generics covered under TRICARE?
No, as of August 31, 2025, TRICARE For Life beneficiaries (retirees over 65) no longer have coverage for weight loss generics like phentermine or liraglutide. This change was mandated by federal law. Active duty members and other beneficiaries may still have coverage depending on their plan and medical necessity. Always check the formulary or call TRICARE directly.
How do I switch to TRICARE Home Delivery for my generics?
Sign up at the Express Scripts TRICARE member portal or call 1-877-363-1303. You’ll need your TRICARE ID, your doctor’s prescription, and your mailing address. You can order 90-day supplies of most generics for $13 (until Dec 31, 2025), then $14 starting January 1, 2026. Delivery takes 7-10 days, so plan ahead.
What if my doctor prescribes a non-formulary generic?
Your provider can submit a prior authorization request through the Express Scripts portal. It usually takes 48 hours to get a decision. About 78% of these requests are approved, especially if you’ve tried other drugs first or if there’s no suitable alternative. Keep a copy of the request and follow up if you don’t hear back in 3 business days.