Pharmacy Copayments

The following copayments ("copays") apply to each prescription fill:

Pharmacy Copay Tier Cost of Prescription per Fill* Estimated Cost of Prescription per Year

Generic Drugs

Tier 1

Mail-Order FREE FREE
USFHP Network Pharmacy $10 $120

Brand Name Drugs

Tier 2

Mail-Order $20 $80
USFHP Network Pharmacy $24 $288

Non-formulary** Drugs

Tier 3

Mail-Order $49 $196
USFHP Network Pharmacy $50 $600

* Retail is for up to a 30-day supply per fill. Mail-Order is for up to a 90-day supply per fill.

** A drug formulary is a list of generic and brand name drugs that are preferred by a health plan. Drugs on the TRICARE formulary are covered in whole or in part. TRICARE regularly reviews drugs for their clinical and cost effectiveness. Non-formulary drugs are not on the list and have higher copays.