Changes in Pharmacy Copays will Begin Jan. 1, 2022

October 20, 2021

On January 1, 2022, changes in pharmacy copayments will take effect. These changes will impact all military health plans. They are required by law. The changes affect TRICARE beneficiaries who are not active duty service members. The new copayments are listed in the chart below.

PLEASE NOTE: These changes do not affect dependent survivors of active duty service members. They also do not affect medically retired service members and their dependents.

COPAY TIER  PHARMACY  COST Rx PER FILL  COST Rx PER YEAR 
Tier 1
Formulary Generics
Mail order or PacMed pharmacies $12 $48
Network pharmacies $14 $168
Tier 2
Formulary Brands
Mail order or PacMed pharmacies $34 $136
Network pharmacies $38 $456
Tier 3
Non-Formulary
Mail order or PacMed pharmacies $68 $272
Network pharmacies $68 $816
Tier 4
Non-Covered Drugs

Full cost of drug Full cost of drug

Prescriptions filled at mail order (MXP) and PacMed clinic pharmacies still provide the lowest copays.

Also, with mail order (MXP) and PacMed clinic pharmacies, you can fill up to a 90-day supply of medication. This means you will have far fewer copayments each year for medications you refill regularly. So, with a Tier 3 drug, you can save up to $544 over one year.

 If you are not using mail order (MXP) but would like to, it’s easy to do. Call Maxor customer service to learn how to move your prescriptions over. The toll-free number is 866-408-2459.