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Injection/Infusion Medication

Injection and infusion medication is a limited benefit. TRICARE covers medications that are approved by the U.S. Food and Drug Administration.

Injection/infusion medications may be administered:

  • In the home by self or caregiver.
  • In the home by a home health agency.
  • In a provider’s office.
  • In another outpatient setting such as an outpatient hospital or ambulatory infusion center.

In most cases, providers may buy and bill medication for outpatient administration or obtain it through a specialty pharmacy (specialty drug supplier). If the pharmacy supplies the medication to the provider’s office, the pharmacy would subsequently bill Health Net Federal Services, LLC for reimbursement. (Please note: There may be certain medications for which the buy and bill process does not apply.)

Specialty drug suppliers can be located using our Network Provider Directory. Providers can submit a request for benefit review to determine coverage. 

Authorization Requirements

If covered, the setting where the services are provided will determine costs; an outpatient officeambulatory surgery setting or a home setting.

Pre-authorization is required for home infusion for all beneficiaries. Pre-authorization is not required for injection/infusion medication when it is provided in a provider's office or other outpatient setting, unless the beneficiary is an active duty service member.