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Catastrophic Cap

Your catastrophic cap is the maximum amount you pay each fiscal yearOctober 1 - September 30.

  • Your cap depends on who you are. 
  • Find your cap below.
If you are ... Your Cap is:
An Active Duty Family $1,000 per family, per fiscal year 
A Family Using TRICARE Reserve Select  $1,000 per family, per fiscal year
All Others $3,000 per family, per fiscal year 

After you reach your catastrophic cap, you won’t have to pay anything more in most cases. But there are some exceptions.

The cap applies to all covered services:

  • annual deductibles (if applicable)
  • pharmacy copayments
  • enrollment fees/monthly premiums (if applicable)
  • other cost shares based on TRICARE-allowable charges.

The cap does not apply to services not covered by TRICARE or to any amount that non-participating providers may charge above the TRICARE maximum allowable chargeThe maximum amount TRICARE pays for each procedure or service.  This is tied by law to Medicare's allowable charges. for services. 

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.

Last Updated 3/2/2016