MOAA’s TRICARE Toolkit provides insight and tips for navigating your TRICARE benefits. Have a question or suggestion for an upcoming column? Email beninfo@moaa.org. Read other TRICARE Toolkit columns at MOAA.org/tricaretoolkit.

TRICARE pharmacy users will see cost increases in 2024 as the Defense Health Agency implements prescription medication copays set by the FY 2018 National Defense Authorization Act (NDAA).

That same legislation gives DoD authority to adjust copays for 2028 and beyond to reflect changes in the cost of pharmaceutical agents and prescription drug dispensing. MOAA already has started discussions on Capitol Hill to establish guardrails on this authority, with the goal of legislation to limit DoD increases on prescription drug copays.

[TAKE ACTION: Urge Your Lawmakers to Restore the TRICARE Pharmacy Retail Network]

As of Jan. 1, TRICARE copays for prescription drugs will increase as follows:

TRICARE Pharmacy Home Delivery (Up to a 90-Day Supply)

• Generic formulary drugs: from $12 to $13
• Brand-name formulary drugs: from $34 to $38
• Non-formulary drugs: from $68 to $76

TRICARE Retail Network Pharmacies (Up to a 30-Day Supply)

• Generic formulary drugs: from $14 to $16
• Brand-name formulary drugs: from $38 to $43
• Non-formulary drugs: from $68 to $76

Prescriptions obtained at military treatment facility (MTF) pharmacies still will have zero out-of-pocket cost.

At retail pharmacies, beneficiaries will continue to pay either the TRICARE copay or the actual retail cost of the drug, whichever is lower. You can check retail cost estimates for your prescription drugs using the Price a Medication tool.

Making MHS Reforms Work for You 

The TRICARE retail and mail-order pharmacy programs were extended to Medicare-eligible retirees in 2001 with the legislation that created TRICARE For Life (TFL). Until then, the only prescription drug benefit available to military retirees ages 65 and up was zero-out-of-pocket-cost prescriptions at MTF pharmacies.

As Congress shaped military health system reforms, MOAA successfully blocked dozens of proposals that would have increased beneficiary cost sharing, including a TFL enrollment fee and catastrophic cap increases up to $5,000.

[RELATED: MOAA's TRICARE Toolkit]

MOAA also objected to fee increases for survivors, as well as for medically retired servicemembers and their families. As a result, protections for these populations were included in the FY 2018 NDAA – their pharmacy copays will remain unchanged next year.

There also will be no change for active duty servicemembers – they will have no out-of-pocket costs for medications obtained at the MTF, a retail pharmacy, or via mail order.

MOAA continues work to restore the TRICARE pharmacy network, cut by nearly 25% due to reduced network requirements in the new TPharm5 contract, with efforts to secure a report to obtain detailed data on beneficiary impact. We appreciate the MOAA members who traveled to Washington, D.C., last month for our Advocacy in Action event and met with lawmakers to explain how pharmacy network cuts impact military families.

Please watch The MOAA Newsletter for updates on our advocacy efforts related to the TRICARE pharmacy benefit, including a call to action to share your perspectives.