2022 TRICARE Copayment Increase
Congress and the Department of Defense (DoD) worked together on these changes, which Congress passed into law as part of the National Defense Authorization Act for Fiscal Year 2018. These changes are part of a larger effort to generate discretionary savings for the DoD to fund improvements in military readiness and to modernize the TRICARE health benefit.
As of 1 January 2022, TRICARE pharmacy copayments will change for all beneficiaries, except active duty service members (ADSMs), dependent survivors of ADSMs, and medically retired service members and their dependents.
Copays for Tier 1 generic formulary drugs, Tier 2 brand-name formulary drugs, and Tier 3 non-formulary drugs are increasing at home delivery and retail points of service.The copayment increases for retail pharmacies and home delivery range from $1 to $8 depending on formulary status.
Military pharmacies remain the lowest cost pharmacy options for TRICARE beneficiaries, who have the option to get generic and brand-name drugs for $0 copayment.
New Copayments
Military Pharmacy Copayments
- Beneficiaries can still fill their generic and brand-name prescriptions for $0 copayment at military pharmacies.
- Non-formulary drugs may only be filled at a military pharmacy if a military provider prescribed the drug, or if the MTF-enrolled beneficiary was referred by the MTF to an outside provider.
