Health Plan Costs
Your costs are different depending on who you are and which health plan option you are using. To see an overview of out-of-pocket costs, please select a plan from the left-hand side of the page.
The maximum amount you'll have to pay each fiscal year (October 1 - September 30) is called the catastrophic cap. This cap applies to annual deductibles, pharmacy copayments, TRICARE Prime enrollment fees and all other copayments or cost shares you pay for TRICARE-covered services. The cap varies depending on who you are:
- Active duty family members: $1,000 per family, per fiscal year
- Beneficiaries enrolled in TRICARE Reserve Select: $1,000 per family, per fiscal year
- All others: $3,000 per family, per fiscal year
In most cases, you're not responsible to pay for any amounts above the catastrophic cap, but there are some exceptions.
What happens to the catastropic cap when an active duty sponsor retires?
When the sponsor retires, the full deductible and cost shares credited towards the previous family cap ($1,000) is credited to the new cap ($3,000) in the same fiscal year.