TRICARE Coverage for Generics: What Military Families Need to Know in 2025

When you're on TRICARE, getting your prescriptions filled shouldn't feel like a maze. For most military families, TRICARE generics are the go-to option - cheaper, just as effective, and covered under nearly every plan. But knowing how it works, where to get them, and what might trip you up can save you time, money, and stress.

How TRICARE Handles Generic Drugs

TRICARE doesn't just cover generic drugs - it pushes them. About 92% of all prescriptions filled through TRICARE in 2025 were for generics. That’s not an accident. The Defense Health Agency designed the system to save money without cutting corners on care. Generic drugs have the same active ingredients, strength, and dosage as brand-name versions. The only differences? The price and the pill shape. And TRICARE knows it: generics cost 80-85% less than brands, saving the program over $1.7 billion every year.

Not every generic is automatically covered, though. TRICARE has a formulary - a list of approved drugs updated monthly. If your doctor prescribes a generic that’s not on that list, you’ll need prior authorization. About 12% of generic prescriptions fall into this category, and 78% of those requests get approved if you show medical need. But waiting 48-72 hours for approval can delay your treatment, especially if you're managing a chronic condition like high blood pressure or diabetes.

Where to Get Your Generics and What You Pay

Your out-of-pocket cost for generics depends entirely on where you fill your prescription. There are three main options:

• Military pharmacies: Zero copay. Always. Whether you’re active duty, a retiree, or a family member, if you fill your prescription at a base pharmacy, you pay nothing. This is the best deal TRICARE offers - and it’s the only one that doesn’t charge anything for generics.
• TRICARE Home Delivery: $13 for a 90-day supply through December 31, 2025. Starting January 1, 2026, it goes up to $14. This is ideal for maintenance meds like cholesterol pills, thyroid meds, or blood pressure drugs. You order online or by phone, and it ships to your door.
• Network retail pharmacies: $16 for a 30-day supply. This is your local CVS, Walgreens, or Rite Aid that accepts TRICARE. It’s convenient if you need a med right away, but you’ll pay more per day than with home delivery.

Compare that to Medicare Part D, where most people pay $7-$10 for generics - but they don’t have the $0 option at military pharmacies. TRICARE’s copays are higher than VA’s (which are free), but VA only covers veterans, not families or active duty. TRICARE’s structure gives broader access, even if it’s not always the cheapest.

What’s Not Covered - And Why

There’s a big exception to the rule: weight loss medications. As of August 31, 2025, TRICARE stopped covering generic weight loss drugs like phentermine for TRICARE For Life beneficiaries - that’s retirees over 65 and their spouses. This change came from a 2024 National Defense Authorization Act rule. About 1.2 million people are affected. Many are frustrated. On forums like Reddit, users say they’re being forced to pay $100+ out of pocket for meds that are FDA-approved and clinically recommended.

Another gray area is generic biologics - newer, complex drugs that mimic biologic treatments. These face higher prior authorization hurdles. About 22% more paperwork is required compared to regular generics. That’s because interchangeability standards aren’t fully settled yet. If you’re on one of these, expect delays and extra documentation.

How to Check If Your Drug Is Covered

Don’t guess. Always check the TRICARE Formulary Search tool at www.esrx.com/tform. Type in the exact drug name and strength. The tool will tell you:

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

The tool was updated in February 2025 to show real-time cost estimates. It’s mobile-friendly and works even if you’re overseas. But here’s the catch: not all retail pharmacists know how to use it. Some still assume “generic” means “covered.” That’s not true. Always double-check before you leave the pharmacy.

Real Stories from TRICARE Users

On Reddit’s r/MilitaryFinance, AirForceMom2023 wrote: “Got my lisinopril filled at base pharmacy today - saved $48 versus retail.” That’s the kind of win TRICARE delivers when you use the right channel.

But not everyone has it easy. A Marine retiree on Military.com shared: “My generic cholesterol med costs $14 for 90 days through home delivery. My civilian friends pay $30 for 30 days.” That’s a 70% savings.

On the flip side, a user in the Military OneSource forum said: “My provider prescribed a generic not on formulary. Had to wait 72 hours for approval - cost me an extra clinic trip.” That’s the pain point. The system works well when you plan ahead. It gets messy when you’re in a rush.

What’s Changing in 2026

TRICARE is rolling out changes to make things smoother:

• Real-time benefit tools by Q3 2026: Your doctor will see your copay and coverage before they even write the script. No more surprises at the pharmacy.
• Step therapy expansion: More drug classes will require you to try a cheaper generic first before getting a pricier one. This isn’t new - it’s already used for pain meds and antidepressants - but it’s expanding to 15 more categories by 2027.
• Pharmacogenomic testing by 2028: For certain high-risk drugs, you might be tested to see how your body processes them. This could prevent side effects and improve outcomes.

These changes are meant to reduce waste, improve safety, and keep costs down. But they also mean more rules. If you’re on multiple meds, especially for chronic conditions, stay informed.

What You Should Do Right Now

Here’s your action plan:

1. Log into the TRICARE Formulary Search tool and check your top 3 prescriptions.
2. If any are non-formulary, talk to your doctor about alternatives - or start the prior authorization process now.
3. Switch to home delivery for maintenance meds. It’s cheaper and more convenient.
4. Use your military pharmacy whenever possible. No copay. No hassle.
5. If you’re over 65 and on weight loss meds, talk to your doctor about alternatives. TRICARE won’t cover them anymore.

Medication adherence for chronic conditions is 82% among TRICARE users - higher than the national average. That’s because when you know the system, you can make it work for you. Don’t let confusion cost you your health.