When you’re on TRICARE, getting your prescriptions shouldn’t feel like a maze. For millions of military families, TRICARE coverage for generics is the backbone of affordable, reliable medication access. But not all generics are treated the same. Some cost $0. Others cost $16. And a few aren’t covered at all-unless you jump through hoops. Here’s what actually happens when you need a generic drug under TRICARE in 2025.
How TRICARE Handles Generics: The Four Tiers
TRICARE doesn’t just say "yes" or "no" to generics. It organizes them into four clear tiers, and where you fill your prescription changes your out-of-pocket cost dramatically.- Tier 1: Generic formulary drugs - These are the most common and cheapest. Over 92% of all TRICARE prescriptions are for these. They’re FDA-approved copies of brand-name drugs, same active ingredient, same effect, but 80-85% cheaper.
- Tier 2: Brand-name formulary drugs - Covered, but cost more. Usually only used if no generic exists or if your doctor says you need the brand.
- Tier 3: Non-formulary drugs - These include some generics that aren’t on the approved list. You can still get them, but only after your doctor proves it’s medically necessary. Approval rates are around 78%.
- Tier 4: Non-covered drugs - Not covered at all. No exceptions. This includes certain weight loss generics as of August 31, 2025, affecting over 1.2 million TRICARE For Life beneficiaries.
Knowing your tier is the first step to saving money. But here’s the catch: just because a drug is a generic doesn’t mean it’s automatically in Tier 1. About 12% of generics require prior authorization.
Where You Fill Your Prescription Changes Everything
Your cost for the same generic drug can vary from $0 to $16 depending on where you go. There are three main ways to get your meds:- Military pharmacies - Best deal. If you’re on TRICARE Prime or TRICARE Select and you’re near a military treatment facility, you can fill your generic prescription with $0 copay. This includes active duty members, retirees, and their families. No paperwork. No waiting. Just walk in and get your lisinopril, metformin, or atorvastatin for free.
- TRICARE Home Delivery - For 90-day supplies, you pay $13 through December 31, 2025. On January 1, 2026, that goes up to $14. This is managed by Express Scripts. It’s convenient for chronic conditions like high blood pressure or diabetes. You get your meds delivered, and it’s often cheaper than retail.
- Network retail pharmacies - CVS, Walgreens, Rite Aid, and others that accept TRICARE. For a 30-day supply of a Tier 1 generic, you pay $16. This rate stays the same through 2026. But here’s the problem: not all pharmacy staff know TRICARE rules. Some try to charge you full price. Always ask if they’re a TRICARE network pharmacy before you pay.
Active duty service members use military pharmacies for 76% of their fills. Retirees? Over 60% use Home Delivery. Why? It’s easier to manage multiple prescriptions, and the 90-day supply cuts down trips.
The TRICARE Formulary Search Tool: Your Secret Weapon
You can’t guess if a drug is covered. You have to check. The official TRICARE Formulary Search tool (on Express Scripts’ site) lets you type in the exact drug name and strength. It tells you:- Which tier it’s on
- What your copay will be
- Whether prior authorization is needed
- Alternative drugs if it’s not covered
This tool was updated in February 2025 to show real-time costs. But many beneficiaries still don’t use it. They assume their doctor’s prescription is automatically covered. That’s a mistake. One Reddit user wrote: "My provider prescribed a generic not on formulary. Had to wait 72 hours for approval. Cost me an extra clinic trip."
Pro tip: Print or screenshot your search results and bring them to the pharmacy. It cuts down confusion and delays.
What’s Not Covered (And Why)
Not every generic is covered. The biggest change in 2025 was the exclusion of weight loss generics like phentermine and liraglutide for TRICARE For Life beneficiaries. This was mandated by the 2024 National Defense Authorization Act. It affects over 1.2 million older beneficiaries who now pay full price-or nothing at all-if they want these drugs.Other non-covered drugs include:
- Over-the-counter medications (even if prescribed)
- Drugs used for cosmetic purposes
- Some generic biologics (like biosimilar insulin), which face 22% higher prior authorization rates than regular generics
Why the exclusions? It’s not about safety. It’s about cost. TRICARE saves $1.7 billion a year by pushing generics. But even then, the program draws lines. Weight loss drugs are expensive and controversial in public health policy. So they were removed from coverage.
How TRICARE Compares to Other Plans
TRICARE’s generic copays are higher than Medicare Part D ($7-$10) and way higher than the VA (free). But TRICARE has something they don’t: free access at military pharmacies. That’s huge. If you live near a base, you’re getting premium coverage at zero cost.Compared to civilian employer plans, TRICARE’s $16 retail copay is actually lower than average. Many private insurers charge $20-$40 for generics. And TRICARE’s 92% generic fill rate is higher than the national average of 90%.
Where TRICARE falls short? Speed. Getting a non-formulary generic approved takes an average of 48 hours. Some require extra lab results or letters from your doctor. That’s frustrating if you’re running out of meds.
Real Stories: What People Are Saying
On Reddit’s r/MilitaryFinance, a November 2025 thread got 87 comments. Seventy-two percent praised TRICARE’s generic coverage. One Marine retiree wrote: "My generic cholesterol med costs $14 for 90 days through Home Delivery. My civilian friends pay $30 for 30 days. I’m saving $100 a month." But not everyone’s happy. Nearly 40% of beneficiaries over 65 are upset about the weight loss drug ban. Others complain about pharmacy staff who don’t know TRICARE rules. One user said: "I was charged $48 at Walgreens because the cashier didn’t know I was TRICARE Prime. Took 20 minutes to fix it." The 2025 TRICARE Beneficiary Survey showed 86% satisfaction with generic access. But 28% of negative reviews cited prior authorization delays. If you’re on a chronic medication, plan ahead.
What’s Changing in 2026
The biggest change? Home Delivery copay goes from $13 to $14 on January 1, 2026. Retail stays at $16. That’s a tiny increase-only $1. Express Scripts predicts it will cut generic fills by just 0.8%. Most people won’t notice.Other updates coming:
- Real-time benefit tools - By Q3 2026, your doctor’s EHR system will show you your TRICARE copay before they even write the prescription.
- Step therapy expansion - Starting in 2027, you may be required to try one generic before moving to another (like trying metformin before a newer diabetes drug).
- Pharmacogenomic testing - By 2028, TRICARE may test your genes before prescribing certain heart or mental health meds to see how you’ll respond.
These aren’t gimmicks. They’re smart moves to reduce waste and improve outcomes. And they’ll likely make your experience smoother in the long run.
What You Should Do Right Now
If you’re on TRICARE and take generics, here’s your action list:- Go to www.esrx.com/tform and search for every drug you take. Save the results.
- If you’re near a military pharmacy, use it. It’s free. No reason not to.
- For chronic meds, sign up for Home Delivery. Save money, save trips.
- Always confirm with the pharmacy that they’re a TRICARE network provider before paying.
- If your drug isn’t covered, ask your doctor to submit a medical necessity request. 78% get approved.
- Call the TRICARE Pharmacy Helpline at 1-877-363-1303 if you’re confused. They handled 1.2 million calls in 2025.
TRICARE’s generic drug coverage isn’t perfect. But for a military health program serving 9.5 million people, it’s one of the most efficient systems out there. You just need to know how to use it.
Are all generic drugs covered by TRICARE?
No. Only generics on the TRICARE Formulary are covered. About 12% of generic drugs require prior authorization because they’re not on the preferred list. Always check the TRICARE Formulary Search tool before filling a prescription.
How much do I pay for a generic drug 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.
Can I use any pharmacy with TRICARE?
Only network pharmacies. These include CVS, Walgreens, Rite Aid, and others that accept TRICARE. Non-network pharmacies may charge you full price, and TRICARE won’t reimburse you unless you’re overseas or in an emergency.
Why was my generic drug denied coverage?
It’s likely not on the TRICARE Formulary, or it’s in Tier 3 (non-formulary). You’ll need a medical necessity request from your doctor. Approval rates are 78%, so don’t give up. You can also ask for an alternative drug that’s covered.
Do TRICARE copays increase every year?
Not every year, but they do adjust. The Home Delivery copay for generics increased from $13 to $14 on January 1, 2026. Retail copays remain at $16 through 2026. These changes are based on pharmacy cost trends and federal guidelines.
Is TRICARE Home Delivery better than retail for generics?
For most people taking chronic medications, yes. Home Delivery offers 90-day supplies for $13-$14, which saves money and reduces trips. Retail is $16 for 30 days, so you’d pay $48 for a 90-day supply. Home Delivery is more cost-effective unless you need your meds immediately.
What if I’m overseas and need a generic?
If you’re overseas, you can fill prescriptions at local pharmacies and submit a claim to TRICARE for reimbursement. You’ll pay the full cost upfront, then file Form 10-7959b with receipts. TRICARE will reimburse you up to the U.S. retail rate, minus your copay.
Sahil jassy
December 18, 2025 AT 13:29Free generics at military pharmacies? Yes please 🙌 I got my metformin for $0 last week and my civilian buddy paid $42 for the same thing. TRICARE actually works when you know how to use it.
Kathryn Featherstone
December 18, 2025 AT 22:25I’ve been using Home Delivery for my blood pressure meds for two years now. $13 for 90 days is a no-brainer. No more rushing to the pharmacy before closing. Just click, wait, and it shows up. Life changed.
mary lizardo
December 19, 2025 AT 21:21It is regrettable that the author fails to acknowledge the systemic inefficiencies inherent in TRICARE’s tiered formulary structure. The arbitrary exclusion of weight loss generics, particularly liraglutide, constitutes a regressive policy that disproportionately impacts elderly beneficiaries with metabolic comorbidities. Moreover, the reliance on Express Scripts as a sole intermediary introduces a dangerous privatization of public healthcare logistics. This is not efficient-it is extractive.
shivam seo
December 21, 2025 AT 20:41Let’s be real-TRICARE is the only reason the U.S. military even functions. Other countries? They can’t even give their soldiers aspirin without a 12-page form. We get free meds, 90-day delivery, and a formulary search tool that actually works. Stop complaining and be grateful.
pascal pantel
December 23, 2025 AT 10:54Let’s cut through the noise. Tier 1 generics are 92% of fills? That’s statistically insignificant unless you control for volume. The real issue is prior authorization latency-48 hours on average for a drug that’s chemically identical to something already on the formulary. That’s not policy, that’s bureaucratic entropy. And the fact that 12% of generics require PA means the formulary is either poorly curated or politically manipulated. Also, why is phentermine excluded but not metformin? The cost differential is negligible. This isn’t cost-saving-it’s ideological.
Andrew Kelly
December 25, 2025 AT 09:41They’re hiding something. Why remove weight loss drugs right after the VA started covering them? Coincidence? No. This is a bait-and-switch. They want you to pay out-of-pocket so they can sell you ‘wellness programs’ later. I’ve seen it happen in civilian insurance. TRICARE’s just the next step. Watch for the ‘preventive care’ upsell next year.
Mahammad Muradov
December 27, 2025 AT 08:47Formulary search tool is useless if your doctor doesn’t use it. I had to go to three pharmacies before one knew TRICARE rules. The system works only if you’re already fluent in its bureaucracy. Most people aren’t. They just want their pills.
Tim Goodfellow
December 28, 2025 AT 13:28TRICARE’s generics are the unsung hero of military healthcare. Free lisinopril? Hell yes. Home delivery for my antidepressants? Lifesaver. Yeah, the $16 retail copay stings-but compared to my cousin’s $38 copay at his HMO? We’re winning. Stop nitpicking and celebrate what actually works.
Aboobakar Muhammedali
December 30, 2025 AT 05:22i just want to say thank you for writing this. my mom is 72 and she cried when she found out her weight loss med wasn’t covered anymore. she’s been trying to get healthy since her heart surgery. i know it’s about costs but… it feels like they gave up on us. i’m gonna call the helpline tomorrow. i’m not giving up.
Laura Hamill
January 1, 2026 AT 01:50THEY’RE LYING TO US!!! 😱 I went to CVS and they charged me $48 for my generic… then I found out they didn’t even know what TRICARE was!! I screamed. I cried. I threatened to call the media. Now I take ALL my meds from the base. NO MORE RETAIL. THEY WANT TO ROB US. I SAW IT IN A DOCUMENT LEAKED ON REDDIT. TRICARE IS BEING SABOTAGED!!
Danielle Stewart
January 1, 2026 AT 18:47Just a gentle reminder: if you’re unsure about your coverage, always call the TRICARE Pharmacy Helpline. They’re trained to help, and they answered over a million calls last year. No need to stress-someone’s there to walk you through it.
Glen Arreglo
January 3, 2026 AT 18:34As someone who’s lived overseas for 12 years, I can confirm the reimbursement system works-if you keep every receipt and file the form within 30 days. It’s not perfect, but it’s the only thing keeping us alive in places where local pharmacies don’t even stock metformin. Grateful for TRICARE.
Isabel Rábago
January 3, 2026 AT 20:17It’s not that TRICARE is bad-it’s that the public doesn’t understand how to navigate it. The real failure isn’t policy, it’s education. Why isn’t this information taught in basic training? Why do new recruits have to learn this through trial and error? That’s the real scandal.