Active duty family members who are enrolled in TRICARE Prime Remote will no longer face copayments for covered prescriptions under a waiver announced Jan. 27.

The change takes effect Feb. 28 and will be automatic – eligible beneficiaries do not need to register or to file reimbursement claims. The waiver does not apply to those on TRICARE Prime Remote Overseas, nor does it apply to any other TRICARE or TRICARE For Life beneficiary.

[RELATED: 1 Visit, 2 Copays? MOAA Helps Military Families Fix Inaccurate TRICARE Claims]

TRICARE Pharmacy copays are outlined in federal statute. Congress provided the authority to reduce copays for TRICARE Prime Remote in the FY 2025 National Defense Authorization Act – the intent is to provide military families stationed remotely with zero-cost prescription medications similar to what is available to active duty families with access to a military treatment facility pharmacy.

TRICARE Prime Remote beneficiaries are still subject to TRICARE Pharmacy Program coverage policies. The Jan. 27 announcement included reminders about other steps eligible beneficiaries may need to take to avoid out-of-pocket costs for prescription medications:

• Those using non-formulary drugs must secure approval from Express Scripts before filling the prescription. Otherwise, the beneficiary will be responsible for the full cost of the medication.
  
  
• Those taking certain maintenance drugs must secure refills via home delivery to avoid paying full price for the medication. TRICARE will pay for only two refills obtained at a retail pharmacy.
  
  
• Medical necessity and prior authorization requirements remain in place for TRICARE to cover any prescription costs.

Learn more about TRICARE Prime Remote eligibility on the TRICARE website.

Active duty servicemembers have no costs for covered drugs when using a military pharmacy, TRICARE Pharmacy Home Delivery, or a TRICARE retail network pharmacy.

More TRICARE Resources From MOAA

• MOAA’s TRICARE Guide: Updated yearly, our comprehensive look at the care benefit includes policy changes, ongoing MOAA advocacy efforts, a TRICARE glossary, and coverage details at key transition points, such as military retirement and reaching age 65. The full guide is available to Premium and Life members.
  
  
• MOAA’s TRICARE Toolkit: Updated monthly, our series looks at issues affecting beneficiaries under a range of TRICARE plans, covers topics like open enrollment and travel concerns, and provides regular updates on plan changes and costs.
  
  
• Transitioning Into Medicare and TRICARE For Life: This publication, exclusive to Premium and Life members, answers frequently asked questions on this coverage changeover, including a timeline for the transition and how to address eligibility issues.