US Family Health Plan

UPDATE

Starting in April 2024, you will access your pharmacy benefits through your Member Portal.


Getting your prescriptions filled is convenient and easy. We offer an excellent pharmacy network.

The prescription drug benefit is comprehensive. You’ll find it’s one of US Family Health Plan’s most valuable benefits!

You can check here to see if your medication is on the TRICARE formulary.   TRICARE Logo

  • Covered medications
  • Any restrictions and preferences for each medication
  • Copayment information, including tiers
  • If the medication requires a Prior Authorization or Medical Necessity Form
  • Limits on medications
  • Information about what medications must be tried first, before your medication can be approved (this is called step-therapy)

How to Use the TRICARE Search Tool User Guide

The TRICARE Formulary Updates are:

  • Developed by the Department of Defense (DOD) Pharmacy and Therapeutics (P&T) Committee
  • Updated Quarterly

You can get your prescription filled at:

Maxor Pharmacies Benefits    

  • Overall satisfaction rating for Maxor Pharmacies was 98.6% in 2019, compared to the national average of 84.7%
  • Short wait times
  • Extended patient counseling by appointment
  • CDC approved vaccine available for FREE
  • Low cost OTC and vitamins for USFHP members
  • Pharmacists available for formulary assistance
  • Provides detailed counseling to promote better health
  • Notifications via text, phone, or e-mail
  • Refill reminders
  • Prescription ready for pick-up
  • Delay in pick-up
  • Pharmacy advocators available to assist in pharmacy benefit 

Pharmacy Co-payments

 Type of Pharmacy Formulary Drugs Non-Formulary  Non-Covered 
   Generic  Brand Name    
 In-Network (up to 30-day supply) $14 $38 $68 Full cost of drug
 MAXOR Mail Order & Walk-In
Maxor Pharmacies (Up to 90-day suppply)
$12 $34 $68 Not available
 Out-of-Network (up to 30 -day supply)  50% of total cost applies after Point of Service (POS) deductible met 50% of total cost applies after POS deductible met 50% of total cost applies after POS deductible met
Full cost of drug

 

The copayments using Mail Order (MXP) remain the lowest copayments available. In addition to lower copayments, you can fill up a 90-day supply of medication using Mail Order (MXP). This can save you over $600 per prescription per year in copayments. If you are not using Mail Order (MXP), call Maxor customer service toll free at 866-408-2459 and ask how to move your prescriptions over.


Copay Increase effective January 1, 2024

USFHP Beneficiary Pharmacy Copay Increase Effective January 1, 2024.

On January 1, 2024, all copayments for prescription drugs for US Family Health Plan will increase. These changes are required by law and affect TRICARE beneficiaries who are not active duty service members.

View copay information here


TRICARE is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved.


Last Updated: 12/08/2023