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TRICARE Operations Manual 6010.59-M, April 1, 2015
TRICARE Pharmacy (TPharm)
Chapter 23
Section 1
Revision:  C-76, October 5, 2020
1.0  General
1.1  The TRICARE Pharmacy (TPharm) Benefits Program offers worldwide services through:
•  Direct Care (DC) pharmacies located at Military Treatment Facilities (MTFs)/Enhanced Multi-Service Markets (eMSMs);
•  Retail network pharmacies;
•  Retail non-network pharmacies;
•  A Mail Order Pharmacy (MOP) program; and
•  Specialty pharmacies.
1.2  The requirements/guidelines in this chapter apply only to the TPharm contractor.
2.0  Eligibility
2.1  The TPharm Benefits Program is available to all beneficiaries who show as TRICARE eligible in Defense Enrollment Eligibility Reporting System (DEERS), as well as direct care only eligible beneficiaries who have access to direct care pharmacy services only. Eligible beneficiaries do not need to enroll separately from any medical enrollment in order to use the pharmacy program.
2.2  The contractor shall refer to Chapter 17, Section 3 for management of Foreign Force Members (FFMs) and their dependents from countries that are party to a North Atlantic Treaty Organization (NATO), Status of Forces Agreement (SOFA), or Partnership for Peace (PfP) SOFA.
2.3  The Government will assess Guard or Service members who are injured or become ill while serving on active duty or performing official drills with their unit for eligibility of continued care/treatment associated with the specific episode of care once their active duty or drill status has terminated. Documentation from Specified Authorization Staff (SAS) will serve as proof of eligibility and pharmaceutical claims shall be processed for reimbursement. SAS, per Chapter 17, Section 2, paragraph 1.2, has authority to approve claims for drugs not covered under standard benefit guidelines.
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