Glossary
Express Scripts
The pharmacy benefit manager that administers the TRICARE Pharmacy Program, including TFL home-delivery and retail-network prescriptions.
Also known as: TRICARE pharmacy contractor, ESI
Quick answer
Express Scripts is the Defense Health Agency's contracted pharmacy benefit manager for the TRICARE Pharmacy Program. It runs TRICARE Home Delivery (mail order), the TRICARE retail pharmacy network, and processes pharmacy claims for active duty, retirees, and TFL beneficiaries.
Why it matters
Because the TRICARE Pharmacy Program through Express Scripts is CMS-certified creditable coverage, TFL beneficiaries do not need (and should not enroll in) a standalone Medicare Part D plan. Express Scripts also issues the annual Creditable Coverage Notice you should keep on file.
Why this matters at age 65
Your Express Scripts account, ID number, and Home Delivery prescriptions carry over unchanged at 65. There is nothing to re-enroll in. Confirm that maintenance medications are set up for 90-day Home Delivery before turning 65 — it is the lowest-cost option for most generics.
When you'll encounter it
Every prescription fill once you're on TFL.
Impact on Medicare
None directly — Express Scripts is a TRICARE contractor, not a Medicare entity. Pharmacy claims do not cross over to or from Medicare.
Impact on TRICARE For Life
Express Scripts is the de facto drug benefit for most TFL beneficiaries. Four points of service: MTF pharmacy (free for formulary), TRICARE Home Delivery (low cost), TRICARE retail network (low copay), non-network retail (highest cost).
Impact on Medicare Advantage
If you enroll in MA-PD, the MA plan's drug benefit operates separately from Express Scripts. You can use whichever is cheaper per drug.
Military-specific context
Express Scripts holds the TRICARE pharmacy contract under DHA. Customer service: 1-877-363-1303. Account management at express-scripts.com/TRICARE.
Common misconceptions
- "I need Part D in addition to Express Scripts." — No. TRICARE Pharmacy via Express Scripts is creditable, so no Part D needed and no late penalty.
- "Express Scripts is a Medicare contractor." — It is a DoD/DHA contractor. Medicare has no authority over TRICARE pharmacy claims.
Common mistakes to avoid
- Continuing 30-day retail refills for maintenance meds instead of shifting to 90-day Home Delivery.
- Throwing away the Creditable Coverage Notice that arrives each fall.
- Letting a pharmacy bill an MA-PD plan first when TRICARE Home Delivery would be cheaper.
Real-world scenario: A retired Army E-9 on TFL fills five generic maintenance medications.
He uses Express Scripts Home Delivery for all five at 90-day supply — total copay ~$60 per quarter. The equivalent at a retail Part D plan would be 3–5× that amount and would force him into a separate Part D deductible structure.
What should I do?
- 1Create or recover your account at militaryrx.express-scripts.com to manage refills and renewals.
- 2Set up TRICARE Home Delivery for every maintenance drug — call 1-877-363-1303 if your prescriber needs to fax the script.
- 3Keep the annual Creditable Coverage Notice; it's your proof of Part D protection.
- 4If a drug is rejected at the pharmacy counter, call Express Scripts before paying cash — usually it's a coordination issue, not a coverage denial.
Questions people commonly ask
- Do I need Part D if I use Express Scripts?
- How do I move prescriptions to Home Delivery?
- What is the Creditable Coverage Notice from Express Scripts?
Continue learning
— suggested by the knowledge graph- What is TRICARE For Life? The complete guide for retired militaryThe Medicare-wraparound benefit you earned through service — what it covers, who qualifies, what it costs, and how it activates.
- How Medicare and TRICARE For Life work togetherThe exact mechanics of who pays first, who pays second, and what you owe — for every common care scenario.
- Using military hospitals and clinics (MTFs) after age 65What changes about Military Treatment Facility access once you become Medicare-eligible — and how to plan for the transition.
- Brand-Name DrugsFDA-approved drugs sold under a manufacturer's proprietary name — middle copay tier on the TRICARE formulary.
- Defense Health Agency (DHA)The DoD combat support agency that runs the Military Health System and administers TRICARE, including TRICARE For Life.
- Generic DrugsChemically identical, FDA-approved equivalents of brand-name drugs — the lowest copay tier under TRICARE Pharmacy.
- Medical NecessityA documented clinical justification that a non-formulary or restricted drug is required — allowing TRICARE to cover it at a lower tier.
- Medicare Part D and TFLWhy TFL beneficiaries do not need (and usually should not enroll in) a standalone Medicare Part D plan.
- Military Pharmacy (MTF Pharmacy)Pharmacies operated inside Military Treatment Facilities — fills formulary drugs at $0 copay for TFL beneficiaries.
- Should I enroll in Medicare Part D?No, for almost every TFL beneficiary. TRICARE Pharmacy (Express Scripts) is creditable coverage and cheaper than most Part D plans. Adding Part D usually costs more without adding benefit.
- Where can I fill prescriptions on TFL?MTF pharmacy (free), TRICARE Pharmacy Home Delivery (Express Scripts, lowest copays for 90-day supplies), or any in-network retail pharmacy.
- What is 'creditable coverage' for Part D?Drug coverage that's at least as good as standard Part D. TRICARE Pharmacy is creditable, so you can skip Part D without owing a late-enrollment penalty later.
- What are the TRICARE Pharmacy copays for retirees?MTF pharmacy: $0. Home Delivery (90-day): low. Retail network (30-day): higher. Non-network: highest and requires a paper claim. Exact amounts adjust annually.
- What if my drug isn't on the TRICARE formulary?Non-formulary drugs cost more. Your doctor can request a medical-necessity exception so it's covered at the formulary copay.
Related lessons
Related glossary terms
Related Official Resources
Continue learning straight from the source. Every link below goes to an official government or DoD resource.
Last reviewed January 2026 against the 2026 Medicare & You and TRICARE For Life handbooks.