TRICARE Guidelines for Retin-A

Both civilian and military treatment facility (MTF) providers should be aware of the TRICARE formulary guidelines for the dispensing of Retin-A (tretinoin). All civilian and MTF pharmacies are required to follow the TRICARE guidelines.

TRICARE beneficiaries need a written prescription and a valid Uniformed Services identification card to fill their prescriptions.

The TRICARE formulary guidelines for Retin-A (tretinoin) are noted below:

• Formulary: Patients under the age of 35 for the treatment of acne
• Non-Formulary: All other patients
• Non-Formulary: Treatment of wrinkles, sun spots, or other cosmetic uses

Eligible TRICARE beneficiaries may fill prescription medications at:

• MTF pharmacies
• TRICARE Mail Order Pharmacy (TMOP)
• TRICARE retail network pharmacies (TRRx)
• Non-network pharmacies

If the beneficiary is over the age of 35, the prescription can be filled either at a retail pharmacy or the mail order pharmacy. However, you will need to contact Mail Order or Retail Customer Service to provide a statement of medical necessity with information showing that use of a topical tretinoin product is clinically required to treat a condition other than wrinkles, age spots or other cosmetic conditions related to the normal aging process. The prescription can also be filled at a MTF pharmacy when accompanied by a statement of medical necessity.

Please note that TRICARE's mandatory generic drug policy requires that prescriptions be filled with a generic product, if one is available.

For more information, refer to the TRICARE Pharmacy Web site at http://www.tricare.mil/pharmacy/.