The Express Scripts benefit: TFL prescriptions in 2026
TRICARE for Life includes prescription coverage through Express Scripts: in 2026, 90-day home delivery costs $14 generic, $44 brand-name, and $85 non-formulary, retail network fills run $16/$48/$85 for 30 days, military pharmacies stay free — and there's no Part D-style donut hole.
The benefit at a glance
- No coverage gap — no Part D-style donut hole, ever
- Mail order: home delivery ships up to 90-day supplies of maintenance medications
- Large national retail network — major chains and independents alike
- Military pharmacies: $0 for covered drugs, up to a 90-day supply, where available
- Creditable for Part D — no separate drug plan needed, no late penalty for skipping one
2026 copays
| Where you fill | Generic | Brand-name | Non-formulary |
|---|---|---|---|
| Military pharmacy (up to 90 days) | $0 | $0 | $0* |
| Home delivery (up to 90 days) | $14 | $44 | $85 |
| Retail network (up to 30 days) | $16 | $48 | $85 |
*Where carried — call the military pharmacy to confirm stock. Non-network pharmacies cost substantially more ($85 or 20% of total, whichever is greater, after a deductible) and some non-formulary drugs are home-delivery-only. Copays rose January 1, 2026 under the FY2018 NDAA schedule; survivors of active-duty members and medically retired members keep prior rates.
Two structural rules worth knowing: TRICARE requires generic substitution when a generic exists (medical-necessity exceptions apply), and most brand-name maintenance drugs must move to home delivery or a military pharmacy after initial retail fills. The Express Scripts formulary search shows each drug's category and where it can be filled.
Cost-per-year reality check
Compare that against a stand-alone Part D plan — roughly $38.99/month national base premium before any copays — and the verdict writes itself: TFL beneficiaries almost never benefit from adding Part D. The exception worth naming is Extra Help: beneficiaries who qualify for the full Part D Low-Income Subsidy sometimes do better with a $0-premium Part D plan, which is a conversation for a benefits counselor, not a default.
If you join an MAPD, this section changes
Pair TFL with a Medicare Advantage plan that includes drug coverage and the MAPD becomes your primary pharmacy benefit — you lose home delivery, and retail fills must run through pharmacies in-network for both plans, billed in sequence. The full mechanics are in the TFL + MA guide; the short version is that an MA-only plan keeps this page true.
Your benefits mix is unique. A licensed agent can review how Medicare options coordinate with your VA, TRICARE for Life, or CHAMPVA coverage — at no cost and no obligation.
Talk to a Licensed AgentOr compare plans yourself at PlanMatch.com, or contact Medicare.gov / 1-800-MEDICARE.
Frequently asked questions
Do TFL beneficiaries need Medicare Part D?
What are TRICARE pharmacy copays in 2026?
Why did my TRICARE drug copays go up in January?
Can I keep using my local pharmacy with TFL?
Does Express Scripts coverage have a deductible?
You earned these benefits. Make them work together.
Whether you keep exactly what you have or add Medicare coverage alongside it, the right answer depends on your health, budget, and how you like to get care.
No cost, no obligation. You can also get help from Medicare.gov, 1-800-MEDICARE (TTY 1-877-486-2048), or your local SHIP office.