US Family Health Plan

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Pharmacy Benefits

The US Family Health Plan has always provided a comprehensive prescription drug benefit to every member, regardless of age. With the price of medication these days, it's more important than ever.

Plan benefit: We cover prescription drugs that are included on the TRICARE Uniform Formulary and that are prescribed by prescribed by a licensed practitioner. See below for more information on the TRICARE Uniform Formulary.

Your cost: Co-payments are required by TRICARE on covered prescription medications, and the amount will depend on whether the drug is generic (Tier 1), brand name - formulary (Tier 2) or non-formulary (Tier 3) and if the drug is obtained at mail order or at a retail pharmacy

  Pharmacy Cost of Prescription per Fill Cost of Prescription per Year
Generic Drugs Maxor Mail Order or at the Fort Wadsworth & Mitchel Field facilities Free Free
Local Pharmacy $5 $60
Brand Name Drugs Maxor Mail Order or at the Fort Wadsworth & Mitchel Field facilities $13 $52
Local Pharmacy $17 $204
Non-Formulary Drugs Maxor Mail Order or at the Fort Wadsworth & Mitchel Field facilities $43 $172
Local Pharmacy $44 $528

Save over 66% on long-term medications: When you use the Maxor Mail Order Pharmacy for long-term medications and prescription refills, you can get a 90-day supply by mail for the same co-payment as a 30-day supply at a participating US Family Health Plan pharmacy. There's no charge for postage or handling. Besides saving money, you'll save the time and trouble of driving to the pharmacy and waiting for your prescriptions to be filled.

How to get your prescriptions filled at participating pharmacies and through mail order:

  • For urgent, short-term acute medications or the first prescription of a newly prescribed medication, for 30 days or less, present your US Family Health Plan member ID card at a participating pharmacy.
  • For maintenance medications used to treat ongoing, chronic illnesses, the Plan requires that they be filled routinely by mail order. Using the Maxor Mail Order Pharmacy saves you time and money. When obtaining an initial prescription for a maintenance medication, have your physician write two prescriptions: one for a 30-day initial supply and one for a 90-day maintenance supply. Fill the initial 30-day prescription at a local participating pharmacy. Then, mail your 90-day prescription to Maxor Mail Order Pharmacy.

    Mail Order Instructions
    1. Members must print and fill out both pages.

    Order Form (inside)     Order Form (outside)

    2. Members can go directly to www.maxor.com to order refills of mail order maintenance medication prescriptions. Refills can also be mailed, faxed or phoned to Maxor Mail Order. For initial fills of maintenance medications, you will need to fill out the paper form and mail it in with the doctor's prescription. Please make sure that your current payment information is available to Maxor Mail Order.

    TRICARE Uniform Formulary
    The TRICARE Uniform Formulary covers most FDA approved prescription medications. Some prescription medications may have TRICARE mandated pre-authorization requirements or quantity limitations. For information on the TRICARE Uniform Formulary click here.

    Click here for the list of prescription medications that have a TRICARE Uniform Formulary pre-authorization requirement.

    Click here for the list of prescription medications that have a TRICARE Uniform Formulary quantity limitation.

    Click here to download a non-formulary brand name request form.

    Click here to download a quantity override request form.

    Click here for a list of injectable medications that have a preauthorization requirement and that are available from Maxor Mail Order.

    Click here for a list of TRICARE Uniform Formulary exclusions.

    Department of Defense Pharmacoeconomic Center

    Pharmacy Locations
    Select one of the locations below to see the list of Maxor participating retail pharmacies near you:

Maxor Retail Pharmacies are conveniently located at the Planís Mitchel Field Family Health Center and the Fort Wadsworth Family Health Center. Click here for more information. To contact the Maxor Mail Order Pharmacy, click here.

To contact Maxor Plus Pharmacy click here.