What to Know About Prior Authorizations for TRICARE Prescriptions

PHOENIX (May 23, 2025) — For Active Duty, family members, and retirees enrolled in a TRICARE health plan, DHA wants beneficiaries to know their medical prescriptions are also covered through its TRICARE Pharmacy Program.

As plan beneficiaries, DHA emphasizes that enrollees should be informed on how medication coverage works and understand important terms such as prior authorization to maximize their prescriptions benefits.

Prior authorization is a routine process ensuring beneficiaries’ prescription medications are medically necessary and cost effective, DHA says. However, beneficiaries should be aware prior authorization is different than pre-authorization. TRICARE plans use pre-authorization to approve certain medical care procedures.

The TRICARE Pharmacy Program often requires prior authorization for certain medications identified under its TRICARE Formulary. The online formulary specifies dosage coverage and contains details about selected medications.

TRICARE enrollees should also know that the US Family Health Plan does not include the TRICARE Pharmacy Program. These enrollees have their own pharmacy plan.

Read more about TRICARE pharmacy coverage in this recent TRICARE News article providing answers about getting prior authorization for TRICARE prescriptions.