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 changes, and pharmacy options, it’s easy to get confused-especially when it comes to generics. The good news? Most of the medications you need are covered. The tricky part? Knowing where to fill them, how much you’ll pay, and what’s actually on the list.

How TRICARE Covers Generic Drugs

TRICARE covers over 5,500 prescription drugs, and about 92% of those are generics. That’s not an accident. The Defense Health Agency pushes generics because they work just like brand-name drugs but cost 80-85% less. The FDA requires them to have the same active ingredients, strength, and dosage form. So if your doctor prescribes a generic, you’re getting the same medicine-not a cheaper version that’s less effective.

But here’s the catch: not every generic is automatically covered. TRICARE has a formulary-a list of approved drugs-and even if a drug is generic, it might not be on that list. If it’s not, you’ll need a prior authorization. In 2024, about 15-20% of requests for non-formulary generics were approved, meaning most people eventually get their meds, but not always right away.

Where You Can Fill Your Prescription and How Much It Costs

Your out-of-pocket cost depends on where you get your prescription. There are three main options:

• Military pharmacies: $0 copay. Always. For active duty, retirees, and their families. If you live near a base, this is your best bet. No paperwork, no waiting, no surprise bills.
• TRICARE Home Delivery (Express Scripts): $13 for a 90-day supply through December 31, 2025. Starting January 1, 2026, it goes up to $14. This is ideal for chronic conditions like blood pressure, diabetes, or cholesterol meds. You order online or by phone, and it arrives in the mail.
• Network retail pharmacies: $16 for a 30-day supply. This is what you pay at pharmacies like CVS, Walgreens, or Rite Aid that are in TRICARE’s network. The price stays the same through 2026.

Outside the U.S. or at non-network pharmacies, costs go up. TRICARE Prime beneficiaries pay 50% of the cost after meeting their deductible. Everyone else pays either $48 or 20% of the total cost-whichever is higher.

How to Check If Your Generic Is Covered

You can’t assume a drug is covered just because it’s generic. You need to check the TRICARE Formulary Search tool. Type in the exact drug name and strength-like “lisinopril 10 mg”-and it tells you:

• Is it on the formulary?
• What tier is it in? (Tier 1 = generic, best price)
• Do you need prior authorization?
• What’s your copay at each pharmacy type?

Many people miss this step. One Marine Corps retiree on Reddit said he filled his generic statin at a retail pharmacy and got hit with a $65 bill because the drug wasn’t on the formulary. He had to go back, get a new prescription, and wait three days for approval. That’s avoidable.

The formulary updates every month. A drug might be covered one month and removed the next if a cheaper alternative becomes available. That’s why checking before you fill is non-negotiable.

What’s Not Covered (And Why)

TRICARE excludes some generics, even if they’re FDA-approved. The biggest change in 2025 was the removal of weight loss medications like phentermine and liraglutide from the formulary for TRICARE For Life beneficiaries (mostly retirees over 65). This went into effect August 31, 2025, after a mandate in the 2024 National Defense Authorization Act.

That’s affected 1.2 million people. Some call it a coverage gap. Others say it’s about cost control-these drugs are expensive and often used long-term. The Defense Health Agency says they’re reviewing clinical evidence and may reconsider in the future.

Another area with trouble? Generic biologics. These are complex drugs, like biosimilars for autoimmune diseases. TRICARE requires 22% more prior authorizations for these than for regular generics. That’s because interchangeability rules are still evolving.

How TRICARE Compares to Other Health Plans

Medicare Part D averages $7-$10 for generics. TRICARE’s $13-$16 copays seem high-but remember, TRICARE has a $0 option at military pharmacies that Medicare doesn’t. VA benefits give free meds to eligible veterans, but only if you’re enrolled in VA care. TRICARE covers more people: active duty, retirees, and their families.

Commercial plans often have wider formularies but higher premiums. TRICARE’s formulary is tighter, but your out-of-pocket costs are lower if you use the right pharmacy. A 2025 Commonwealth Fund report ranked TRICARE third among U.S. government health programs for generic drug access-behind Medicare Advantage but ahead of Medicaid.

Real Stories: What Beneficiaries Are Saying

On Reddit’s r/MilitaryFinance, most people praise the $0 copay at military pharmacies. One user wrote: “Got my lisinopril filled at base pharmacy today-saved $48 versus retail.”

But complaints are common too. A lot of retirees are frustrated about the weight loss drug exclusion. Others mention delays in prior authorization. One post from January 2026 said: “My provider prescribed a generic not on formulary. Had to wait 72 hours for approval. Cost me an extra clinic trip.”

The most consistent feedback? If you use military pharmacies or home delivery, you’re fine. If you go to a retail pharmacy without checking the formulary first, you risk paying more.

What You Need to Do Right Now

Don’t wait for a surprise bill. Here’s your action plan:

1. Go to www.esrx.com/tform and search for every medication you or your family takes.
2. Write down the copay for each pharmacy type: military, home delivery, retail.
3. If a drug isn’t on the formulary, call your provider. Ask if there’s an alternative that is covered.
4. For chronic meds, switch to home delivery. It’s cheaper and more convenient.
5. Keep the TRICARE Pharmacy Helpline handy: 1-877-363-1303. They handled over 1.2 million calls in 2025.

Also, mark your calendar: January 1, 2026, is when home delivery copays go up to $14. If you’re on a 90-day supply, you’ll pay $14 every three months instead of $13. That’s a $4 increase a year-small, but worth knowing.

What’s Coming in 2026 and Beyond

TRICARE isn’t standing still. By Q3 2026, providers will see real-time cost and coverage info when they write a prescription. That means fewer surprises at the pharmacy.

Step therapy is expanding-meaning you might need to try one generic before moving to another. And by 2028, TRICARE plans to use pharmacogenomic testing for certain drugs. That’s when your DNA helps determine which medication works best for you.

By 2030, experts predict 94% of TRICARE prescriptions will be generics. That’s good news for the program’s budget-and for your wallet.

Final Thought: Generics Are Your Friend

TRICARE’s system isn’t perfect. There are delays, exclusions, and confusing rules. But if you know how to use it, you can save hundreds-or even thousands-of dollars a year. Generics are safe, effective, and heavily favored by the program. The key is staying informed and using the right pharmacy.

Don’t guess. Don’t assume. Search the formulary. Call the helpline. Fill at the base if you can. That’s how you make TRICARE work for you.