Comprehensive Coverage

Pharmacy information

Walgreens Stores: Johns Hopkins US Family Health plan has added all Walgreens pharmacies to the network—that’s 8,100 locations and growing. In addition to convenient locations, Walgreens has many digital tools to help our members manage medication and easily refill prescriptions.

We offer two convenient ways for our members to receive their prescriptions:

  • Home delivery: Available to members for up to a 90-day supply of approved medications
  • Retail pharmacy pick-up: Fill and pick up your prescriptions at any of our network pharmacies nationwide without having to submit a claim. Through our retail pharmacy network, you can fill a 30-day supply of your everyday medications, or a 90-day supply of medications for a chronic condition, for the same copay as home delivery.

Search for local Walgreens pharmacies that are in the USFHP pharmacy network by visiting the Caremark Pharmacy Locator and entering your ZIP code, city and state, or county and state.

Please note that the USFHP pharmacy network is limited to Walgreens pharmacies. Some Walgreens-owned pharmacies on this site may still be listed as Rite Aid. Please check with the pharmacy that it is a Walgreens-owned pharmacy.

Prescription drug coverage

Johns Hopkins USFHP utilizes the TRICARE pharmacy formulary. The formulary lists all of the prescription drugs that are covered under the TRICARE benefit. It is a tiered, open formulary, and includes:

  • Generic drugs (Tier 1)
  • Preferred brand drugs (Tier 2)
  • Non-preferred brand drugs (Tier 3)

Each of these tiers represents a cost share that USFHP members are responsible for paying.

See if a specific drug is covered and its cost share

Other covered medication

Our pharmacy program provides outpatient coverage to members for medications that are approved for marketing by the U.S. Food and Drug Administration (FDA) and that generally require prescriptions. Other covered medications include:

  • Compounded medications of which at least one ingredient is a legend drug
  • Insulin
  • Insulin syringes and needles
  • Glucose test strips
  • Lancets

Non-covered medications

Prescription medications that are used to treat conditions not currently covered by USFHP by statute or regulation are excluded from the pharmacy benefit. Excluded medications include:

  • Drugs prescribed for cosmetic purposes
  • Fluoride preparations
  • Food supplements
  • Homeopathic and herbal preparations
  • Multivitamins
  • Over-the-counter products (except insulin, diabetic supplies, and select OTC products)

Copayments

Copayments for prescription drugs may vary depending on the type of drug and its day-supply.

Prescription drugs that are picked up at a retail network pharmacy for up to a 30-day supply:

  • $16 for generic drugs
  • $43 for brand name drugs
  • $76 for non-formulary drugs

Home delivery of a prescription drug for up to a 90-day supply (maintenance medications only):

  • $13 for generic drugs
  • $38 for brand name drugs
  • $76 for non-formulary drugs

You can view the cost share for a medication using the TRICARE formulary search tool. You can also search for lower cost alternatives to a medication you are currently taking.

Manage your health information: online coordination of benefits

US Family Health Plan members who have Other Health Insurance (OHI) can take advantage of online coordination of benefits (COB).

Advantages of having your COB claims processed online include:

  • Zero out-of-pocket expense
  • No need to submit paper claims
  • Reduced or eliminated up-front costs

US Family Health Plan becomes the first payer when:

  • The drug is not covered by your OHI, but is covered by TRICARE
  • Coverage under your OHI is exhausted for the benefit year

If you are using a mail order program available through your OHI, online COB is not an option.

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