| 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). The co-payment for generic prescriptions is $3, brand name prescriptions are $9, and prescriptions for TRICARE 3rd Tier non-formulary medications are $22. This fee will cover up to a 30-day supply when filled at a participating pharmacy or up to a 90-day supply when filled by Maxor Mail Order Pharmacy.
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. The same $3 co-payment for generic drugs, $9 copayment for brand-name drugs, or $22 co-payment for non-formulary 3rd Tier drugs also applies, but you get a 90-day supply of medication by mail for the same cost as a 30-day supply of medication from your local participating pharmacy. This saves you over 66% of the cost, as well as the time of going to the pharmacy and waiting for your prescriptions to be filled.
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.
Click here for the list of TRICARE Uniform Formulary Tier 3 medications.
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 Plan’s 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.
