TRICARE Prime & TRICARE Select
Costs for active duty family members and transitional survivors
- Active duty service members don’t have out-of-pocket costs.
- “Network” means a provider in the TRICARE network. “Non-network” means a TRICARE-authorized provider not in the TRICARE network.
- Cost-shares are percentages of the TRICARE maximum-allowable charge after the annual deductible is met.
| Cost Type | TRICARE Prime — Group A | TRICARE Select — Group A |
|---|---|---|
| Enrollment fee (annual) | $0 | $0 |
| Deductible (annual) | $0 | Pay grades E-1 through E-4: $50 per individual $100 per family Pay grades E-5 and above: $150 per individual $300 per family |
| Catastrophic cap (annual) | $1,000 per family | $1,000 per family |
| Preventive care | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $0 |
| Outpatient visit — primary care | Network: $0 Non-network: Point-of-service fees |
Network: $30 Non-network: 20% |
| Outpatient visit — specialty care | Network: $0 Non-network: Point-of-service fees |
Network: $39 Non-network: 20% |
| Urgent care | Network provider or TRICARE-authorized urgent care center: $0 Any other urgent care provider: Point-of-service fees |
Network: $30 Non-network: 20% |
| Emergency visit | Network or non-network: $0 |
Network: $107 Non-network: 20% |
| Laboratory and X-ray services | Network: $0 Non-network: Point-of-service fees |
Network: $0 Non-network: 20% |
| Ambulatory surgery | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $25 |
| Ambulance | Network or non-network: $0 |
Outpatient (ground): Network: $86; Non-network: 20% Outpatient (air): 20% (network or non-network) Inpatient: 20% |
| Mental health — inpatient admission | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $25.45 per day |
| Mental health (outpatient care/partial hospitalization) — specialty care | Network: $0 Non-network: Point-of-service fees |
Network: $39 Non-network: 20% |
| Mental health — residential treatment center | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $25.45 per day |
| Durable medical equipment | Network: $0 Non-network: Point-of-service fees |
Network: 15% Non-network: 20% |
| Home healthcare | Network or non-network: $0 | Network or non-network: $0 |
| Hospice care | Network or non-network: $0 | Network or non-network: $0 |
| Hospitalization (inpatient admission) | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $25.45 per day |
| Maternity — hospital delivery | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $25.45 per day |
| Maternity — birthing center delivery | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $25 |
| Maternity — delivery at home (primary care) | Network: $0 Non-network: Point-of-service fees |
Network: $30 Non-network: 20% |
| Maternity — delivery at home (specialty care) | Network: $0 Non-network: Point-of-service fees |
Network: $39 Non-network: 20% |
| Inpatient skilled nursing facility/rehab facility | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $25.45 per day |
TRICARE Prime & TRICARE Select
Costs for active duty family members and transitional survivors
- Active duty service members don’t have out-of-pocket costs.
- “Network” means a provider in the TRICARE network. “Non-network” means a TRICARE-authorized provider not in the TRICARE network.
- Cost-shares are percentages of the TRICARE maximum-allowable charge after the annual deductible is met.
| Cost Type | TRICARE Prime — Group B | TRICARE Select — Group B |
|---|---|---|
| Enrollment fee (annual) | $0 | $0 |
| Deductible (annual) | $0 | Pay grades E-1 through E-4: $68 per individual $137 per family Pay grades E-5 and above: $205 per individual $411 per family |
| Catastrophic cap (annual) | $1,372 per family |
$1,372 per family |
| Preventive care | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $0 |
| Outpatient visit — primary care | Network: $0 Non-network: Point-of-service fees |
Network: $20 Non-network: 20% |
| Outpatient visit — specialty care | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Urgent care | Network provider or TRICARE-authorized urgent care center: $0 Any other urgent care provider: Point-of-service fees |
Network: $27 Non-network: 20% |
| Emergency visit | Network or non-network: $0 |
Network: $54 Non-network: 20% |
| Laboratory and X-ray services | Network: $0 Non-network: Point-of-service fees |
Network: $0 Non-network: 20% |
| Ambulatory surgery | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Ambulance | Network or non-network: $0 |
Outpatient (ground): Network: $20; Non-network: 20% Outpatient (air): 20% (network or non-network) Inpatient: 20% |
| Mental health — inpatient admission | Network: $0 Non-network: Point-of-service fees |
Network: $82 per admission Non-network: 20% |
| Mental health (outpatient care/partial hospitalization) — specialty care | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Mental health — residential treatment center | Network: $0 Non-network: Point-of-service fees |
Network: $34 per day Non-network: $68 per day |
| Durable medical equipment | Network: $0 Non-network: Point-of-service fees |
Network: 10% Non-network: 20% |
| Home healthcare | Network or non-network: $0 | Network or non-network: $0 |
| Hospice care | Network or non-network: $0 | Network or non-network: $0 |
| Hospitalization (inpatient admission) | Network: $0 Non-network: Point-of-service fees |
Network: $82 per admission Non-network: 20% |
| Maternity — hospital delivery | Network: $0 Non-network: Point-of-service fees |
Network: $82 per admission Non-network: 20% |
| Maternity — birthing center delivery | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Maternity — delivery at home (primary care) | Network: $0 Non-network: Point-of-service fees |
Network: $20 Non-network: 20% |
| Maternity — delivery at home (specialty care) | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Inpatient skilled nursing facility/rehab facility | Network: $0 Non-network: Point-of-service fees |
Network: $34 per day Non-network: $68 per day |
TRICARE Prime & TRICARE Select
Costs for all retirees, their family members, survivors, and others
- “Network” means a provider in the TRICARE network. “Non-network” means a TRICARE-authorized provider not in the TRICARE network.
- Cost-shares are percentages of the TRICARE maximum-allowable charge after the annual deductible is met.
| Cost Type | TRICARE Prime — Group A | TRICARE Select — Group A |
|---|---|---|
| Enrollment fee (annual) |
Individual: $396 Note: Your enrollment fee is waived if you’re under age 65 and you have Medicare Part A and Part B. |
Individual: $193.92 |
| Deductible (annual) | $0 | Individual: $150 Family: $300 |
| Catastrophic cap (annual) | $3,000 per family | $4,538 per family $3,000 per family for medically retired sponsors, their family members, and survivors |
| Preventive care | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $0 |
| Outpatient visit — primary care | Network: $27 Non-network: Point-of-service fees |
Network: $40 Non-network: 25% |
| Outpatient visit — specialty care | Network: $41 Non-network: Point-of-service fees |
Network: $52 Non-network: 25% |
| Urgent care | Network provider or TRICARE-authorized urgent care center: $41 Any other urgent care provider: Point-of-service fees |
Network: $40 Non-network: 25% |
| Emergency visit | Network or non-network: $82 | Network: $143 Non-network: 25% |
| Laboratory and X-ray services | Network: $0 Non-network: Point-of-service fees |
Network: $0 Non-network: 25% |
| Ambulatory surgery | Network: $82 Non-network: Point-of-service fees |
Network: 20% Non-network: 25% |
| Ambulance |
Outpatient (ground): $54 Outpatient (air): $20 Inpatient: 25% |
Outpatient (ground): Network: $115; Non-network: 25% Outpatient (air): 25% (network or non-network) Inpatient: 25% |
| Mental health — inpatient admission | Network or non-network: $205 per admission |
Network: $250 per day or up to 25% of hospital charges (whichever is less), plus 20% of separately billed services Non-network: $1,345 per day* or up to of 25% hospital charge (whichever is less), plus 25% of separately billed services |
| Mental health (outpatient care/partial hospitalization) — specialty care | Network: $41 Non-network: Point-of-service fees |
Network: $52 Non-network: 25% |
| Mental health — residential treatment center | Network: $41 per day Non-network: Point-of-service fees |
Network: $250 per day or up to 25% of hospital charges (whichever is less), plus 20% of separately billed services Non-network: 25% |
| Durable medical equipment | Network: 20% Non-network: Point-of-service fees |
Network: 20% Non-network: 25% |
| Home healthcare | Network or non-network: $0 |
Network or non-network: $0 |
| Hospice care | Network or non-network: $0 | Network or non-network: $0 |
| Hospitalization (inpatient admission) | Network or non-network: $205 per admission | Network: $250 per day or up to 25% of hospital charges (whichever is less), plus 20% of separately billed services Non-network: $1,345 per day* or up to 25% of hospital charges (whichever is less), plus 25% of separately billed services |
| Maternity — hospital delivery |
Network or non-network: $205 per admission |
Network: $250 per day or up to 25% of hospital charges (whichever is less), plus 20% of separately billed services Non-network: $1,345 per day* or up to 25% of hospital charges (whichever is less), plus 25% of separately billed services |
| Maternity — birthing center delivery | Network: $82 Non-network: Point-of-service fees |
Network: 20% Non-network: 25% |
| Maternity — delivery at home (primary care) | Network: $27 Non-network: Point-of-service fees |
Network: $40 Non-network: 25% |
| Maternity — delivery at home (specialty care) | Network: $41 Non-network: Point-of-service fees |
Network: $52 Non-network: 25% |
| Inpatient skilled nursing facility/rehab facility | Network: $41 per day Non-network: Point-of-service fees |
Network: $250 per day or up to 25% of hospital charges (whichever is less), plus 20% of separately billed services Non-network: 25% |
*Cost through Dec. 31, 2026. All final claims reimbursed under the TRICARE Diagnosis Related Group-based payment system are to be priced using the rules, weights, and rates in effect as of the date of discharge.
TRICARE Prime enrollment fee for medically retired sponsors, their family members, and survivors in Group A
Your enrollment fee freezes at the rate when you were classified in DEERS as medically retired or as a survivor and enrolled in TRICARE Prime. It stays frozen as long as there is no break in your TRICARE Prime enrollment.
| Date of Classification in DEERS | Annual Enrollment Fee |
|---|---|
| Starting Jan. 1, 2027 | Individual: $396 Family: $792.96 |
| Between Jan. 1, 2026 and Dec. 31, 2026 | Individual: $381.96 Family: $765 |
| Between Jan. 1, 2025 and Dec. 31, 2025 | Individual: $372 Family: $744 |
| Between Jan. 1, 2024 and Dec. 31, 2024 | Individual: $363 Family: $726 |
| Between Jan. 1, 2023 and Dec. 31, 2023 | Individual: $351.96 Family: $703.92 |
| Between Jan. 1, 2022 and Dec. 31, 2022 | Individual: $323 Family: $647 |
| Between Jan. 1, 2021 and Dec. 31, 2021 | Individual: $303 Family: $606 |
| Between Jan. 1, 2020 and Dec. 31, 2020 | Individual: $300 Family: $600 |
| Between Jan. 1, 2019 and Dec. 31, 2019 | Individual: $297 Family: $594 |
| Between Jan. 1, 2018 and Dec. 31, 2018 | Individual: $289.08 Family: $578.16 |
| Between Oct. 1, 2015 and Dec. 31, 2017 | Individual: $282.60 Family: $565.20 |
| Between Oct. 1, 2014 and Sept. 30, 2015 | Individual: $277.92 Family: $555.84 |
| Between Oct. 1, 2013 and Sept. 30, 2014 | Individual: $273.84 Family: $547.68 |
| Between Oct. 1, 2012 and Sept. 30, 2013 | Individual: $269.28 Family: $538.56 |
| Between Oct. 1, 2011 and Sept. 30, 2012 | Individual: $260 Family: $520 |
| Before Oct. 1, 2011 | Individual: $230 Family: $460 |
TRICARE Prime & TRICARE Select
Costs for retirees, their family members, survivors, and others
- “Network” means a provider in the TRICARE network. “Non-network” means a TRICARE-authorized provider not in the TRICARE network.
- Cost-shares are percentages of the TRICARE maximum-allowable charge after the annual deductible is met.
| Cost Type | TRICARE Prime — Group B |
TRICARE Select — Group B |
|---|---|---|
| Enrollment fee (annual) | Individual: $480 Family: $960 |
Individual: $616.92 Family: $1,233.96 |
| Deductible (annual) | $0 | Individual (network): $205 Individual (non-network): $411 Family (network): $411 Family (non-network): $823 |
| Catastrophic cap (annual) | $4,802 per family | $4,802 per family |
| Preventive care | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $0 |
| Outpatient visit — primary care | Network: $27 Non-network: Point-of-service fees |
Network: $34 Non-network: 25% |
| Outpatient visit — specialty care | Network: $41 Non-network: Point-of-service fees |
Network: $54 Non-network: 25% |
| Urgent care | Network provider or TRICARE-authorized urgent care center: $41 Any other urgent care provider: Point-of-service fees |
Network: $54 Non-network: 25% |
| Emergency visit | Network or non-network: $82 |
Network: $109 Non-network: 25% |
| Laboratory and X-ray services | Network: $0 Non-network: Point-of-service fees |
Network: $0 Non-network: 25% |
| Ambulatory surgery | Network: $82 Non-network: Point-of-service fees |
Network: $130 Non-network: 25% |
| Ambulance | Outpatient (ground): $54 Outpatient (air): $20 Inpatient: 25% |
Outpatient (ground): Network: $82; Non-network: 25% Outpatient (air): 25% (network or non-network) Inpatient: 25% |
| Mental health — inpatient admission | Network or non-network: $205 per admission |
Network: $240 per admission Non-network: 25% |
| Mental health (outpatient care/partial hospitalization) — specialty care | Network: $41 Non-network: Point-of-service fees |
Network: $54 Non-network: 25% |
| Mental health — residential treatment center | Network: $41 per day Non-network: Point-of-service fees |
Network: $68 per day Non-network: $411 per day or 20% (whichever is less) |
| Durable medical equipment | Network: 20% Non-network: Point-of-service fees |
Network: 20% Non-network: 25% |
| Home healthcare | Network or non-network: $0 | Network or non-network: $0 |
| Hospice care | Network or non-network: $0 | Network or non-network: $0 |
| Hospitalization (inpatient admission) | Network or non-network: $205 per admission |
Network: $240 per admission Non-network: 25% |
| Maternity — hospital delivery | Network or non-network: $205 per admission |
Network: $240 per admission Non-network: 25% |
| Maternity — birthing center delivery | Network: $82 Non-network: Point-of-service fees |
Network: $130 Non-network: 25% |
| Maternity — delivery at home (primary care) | Network: $27 Non-network: Point-of-service fees |
Network: $34 Non-network: 25% |
| Maternity — delivery at home (specialty care) | Network: $41 Non-network: Point-of-service fees |
Network: $54 Non-network: 25% |
| Inpatient skilled nursing facility/rehab facility | Network: $41 per day Non-network: Point-of-service fees |
Network: $68 per day Non-network: $411 per day or 20% (whichever is less) |
TRICARE For Life
Below are calendar year 2026 costs for certain Medicare and TRICARE-covered services in the U.S. and U.S. territories. For more information, visit the Medicare website and download the TRICARE For Life Cost Matrix.
General Costs
| Cost Type | Medicare | TRICARE |
|---|---|---|
|
Premium/ |
Medicare Part A premiums: $0 for most people Medicare Part B premiums: Monthly premiums based on your income |
$0 If you’re eligible for premium-free Medicare Part A, you must have Medicare Part A and Part B to have TFL. |
|
Deductible |
Medicare Part A: $1,736 (per benefit period) Medicare Part B: $283 (annual) TRICARE pays your Medicare deductibles for services covered by Medicare and TRICARE. |
$150 per individual or $300 per family (annual) You must pay the TRICARE deductible when TRICARE is the only payer. |
|
Not applicable |
$3,000 per family (annual) |
Costs for Care
Medicare pays the Medicare-approved amount for Medicare-covered services you get from doctors or suppliers who accept Medicare assignment. If you use a doctor or supplier who doesn’t accept assignment, TRICARE may pay up to 15% over the Medicare-approved amount.
| Type of Service | Medicare Pays | TRICARE Pays | You Pay |
|---|---|---|---|
| Covered by Medicare and TRICARE | Medicare-approved amount | Remaining amount | Nothing |
| Covered by Medicare only | Medicare-approved amount |
Nothing |
Medicare deductible and cost-share |
| Covered by TRICARE only | Nothing |
TRICARE-allowable amount | TRICARE deductible and cost-share |
| Not covered by Medicare or TRICARE | Nothing |
Nothing |
Billed charges (which may exceed the Medicare-approved or TRICARE-allowable amount) |
Medicare Part A
Medicare Part A covers medically necessary inpatient care you get in the U.S. or U.S. territories. Learn more about Medicare inpatient care coverage.
Hospital Stay (Medical, Surgical, and Mental Health)
| Number of Days | Medicare Pays | TRICARE Pays | You Pay |
|---|---|---|---|
| 1–60 days | 100% after you meet your $1,736 Medicare Part A deductible each benefit period | Your $1,736 Medicare Part A deductible | $0 for services paid by Medicare and TRICARE |
| 61–90 days | All but $434 per day each benefit period | $434 per day |
$0 for services paid by Medicare and TRICARE |
| 91–150 days (lifetime reserve days) | All but $868 per day each benefit period | $868 per day | $0 for services paid by Medicare and TRICARE |
| 151 days or more | Nothing | As the primary payer | Your TRICARE cost-share Call the TFL contractor for details: 866-773-0404 (TDD: 866-773-0405) |
Skilled Nursing Facility
| Number of Days | Medicare Pays | TRICARE Pays | You Pay |
|---|---|---|---|
| 1–20 days | 100% | Nothing | $0 for services paid by Medicare and TRICARE |
| 21–100 days | All but $217 per day each benefit period | $217 per day |
$0 for services paid by Medicare and TRICARE |
| 101 days or more | Nothing | As the primary payer — You must get pre-authorization from the TFL contractor. | Your TRICARE cost-share Call the TFL contractor for details: 866-773-0404 (TDD: 866-773-0405) |
Hospice Care
| Medicare Pays | TRICARE Pays | You Pay |
|---|---|---|
| 100% | Nothing | $0 for services paid by Medicare and TRICARE |
Medicare Part B
Medicare Part B covers medically necessary outpatient care you get in the U.S. or U.S. territories.
Medicare pays after you meet the annual Medicare Part B deductible. TRICARE pays your Medicare Part B deductible for services covered by Medicare and TRICARE.
| Covered Outpatient Service | Medicare Pays | TRICARE Pays | You Pay |
|---|---|---|---|
| Doctor and other healthcare provider services | 80% | 20% | $0 for services paid by Medicare and TRICARE |
| Preventive and screening services | 100% | Nothing | $0 for services paid by Medicare and TRICARE |
| Emergency department services | 80% of the facility and doctor’s charges | 20% plus Medicare copayments |
$0 for services paid by Medicare and TRICARE |
| Ambulance services | 80% | 20% | $0 for services paid by Medicare and TRICARE |
| Outpatient hospital services | 80% | 20% plus Medicare copayments |
$0 for services paid by Medicare and TRICARE |
| Urgently needed care | 80% | 20% (plus Medicare copayment if in a hospital outpatient setting) | $0 for services paid by Medicare and TRICARE |
| Clinical laboratory tests | 100% | Nothing | $0 for services paid by Medicare and TRICARE |
| Diagnostic laboratory tests | 100% | Nothing | $0 for services paid by Medicare and TRICARE |
| Diagnostic non-laboratory tests (radiology) | 80% | 20% | $0 for services paid by Medicare and TRICARE |
| Home health services | 100% | Nothing | $0 for services paid by Medicare and TRICARE |
| Durable medical equipment | 80% | 20% | $0 for services paid by Medicare and TRICARE |
| Mental health services (outpatient) | 80% | 20% (plus Medicare copayment if in a hospital outpatient setting) | $0 for services paid by Medicare and TRICARE |
| Chiropractic services | 80% | Nothing | 20% Medicare cost-share |
TRICARE For Life Overseas
Medicare doesn’t pay for care you get outside the U.S. and U.S. territories. (You must pay Medicare Part B premiums to have TFL overseas.) Learn more at Using TRICARE For Life Overseas.
Costs for TRICARE-Covered Services (Network Providers)
| Medicare Pays | TRICARE Pays | You Pay |
|---|---|---|
| Nothing | As the primary payer (after you meet your TRICARE annual deductible) | 25% cost-share |
Note: There may be no limit to the amount that nonparticipating non-network providers can bill. You’re responsible for paying any amount that exceeds the TRICARE-allowable charge, in addition to your deductible and cost-shares.
TRICARE Reserve Select
- “Network” means a provider in the TRICARE network. “Non-network” means a TRICARE-authorized provider not in the TRICARE network.
- Cost-shares are percentages of the TRICARE maximum-allowable charge after the annual deductible is met.
| Cost Type | TRICARE Reserve Select |
|---|---|
| Premium (monthly) | Member only: $60.54 Member and family: $307.48 |
| Deductible (annual) | Pay grades E-1 through E-4: $68 per individual $137 per family Pay grades E-5 and above: $205 per individual $411 per family |
| Catastrophic cap (annual) | $1,372 per family |
| Preventive care | Network or non-network: $0 |
| Outpatient visit — primary care | Network: $20 Non-network: 20% |
| Outpatient visit — specialty care |
Network: $34 |
| Urgent care | Network: $27 Non-network: 20% |
| Emergency visit | Network: $54 Non-network: 20% |
| Laboratory and X-ray services | Network: $0 Non-network: 20% |
| Ambulatory surgery | Network: $34 Non-network: 20% |
| Ambulance | Outpatient (ground): Network: $20; Non-network: 20% Outpatient (air): 20% (network or non-network) Inpatient: 25% |
| Mental health — inpatient admission |
Network: $82 per admission |
| Mental health (outpatient/partial hospitalization) — specialty care | Network: $34 Non-network: 20% |
| Mental health — residential treatment center | Network: $34 per day Non-network: $68 per day |
| Durable medical equipment | Network: 10% Non-network: 20% |
| Home healthcare | Network or non-network: $0 |
| Hospice care | Network or non-network: $0 |
| Hospitalization (inpatient admission) | Network: $82 per admission Non-network: 20% |
| Maternity — hospital delivery | Network: $82 per admission Non-network: 20% |
| Maternity — birthing center delivery | Network: $34 Non-network: 20% |
| Maternity — delivery at home (primary care) | Network: $20 Non-network: 20% |
| Maternity — delivery at home (specialty care) | Network: $34 Non-network: 20% |
| Inpatient skilled nursing facility/rehab facility | Network: $34 per day Non-network: $68 per day |
TRICARE Retired Reserve
- “Network” means a provider in the TRICARE network. “Non-network” means a TRICARE-authorized provider not in the TRICARE network.
- Cost-shares are percentages of the TRICARE maximum-allowable charge after the annual deductible is met.
| Cost Type | TRICARE Retired Reserve |
|---|---|
| Premium (monthly) | Member only: $707.59 Member and family: $1,697.70 |
| Deductible (annual) |
Individual (network): $205 Family (network): $411 |
| Catastrophic cap (annual) | $4,802 per family |
| Preventive care | Network or non-network: $0 |
| Outpatient visit — primary care | Network: $34 Non-network: 25% |
| Outpatient visit — specialty care | Network: $54 Non-network: 25% |
| Urgent care | Network: $54 Non-network: 25% |
| Emergency visit | Network: $109 Non-network: 25% |
| Laboratory and X-ray services | Network: $0 Non-network: 25% |
| Ambulatory surgery | Network: $130 Non-network: 25% |
| Ambulance | Outpatient (ground): Network: $82; Non-network: 25% Outpatient (air): 25% (network or non-network) Inpatient: 25% |
| Mental health — inpatient admission | Network: $240 per admission Non-network: 25% |
| Mental health (outpatient care/partial hospitalization) — specialty care | Network: $54 Non-network: 25% |
| Mental health — residential treatment center | Network: $68 per day Non-network: $411 per day or 20% (whichever is less) |
| Durable medical equipment | Network: 20% Non-network: 25% |
| Home healthcare | Network or non-network: $0 |
| Hospice care | Network or non-network: $0 |
| Hospitalization (inpatient admission) | Network: $240 per admission Non-network: 25% |
| Maternity — hospital delivery | Network: $240 per admission Non-network: 25% |
| Maternity — birthing center delivery | Network: $130 Non-network: 25% |
| Maternity — delivery at home (primary care) | Network: $34 Non-network: 25% |
| Maternity — delivery at home (specialty care) | Network: $54 Non-network: 25% |
| Inpatient skilled nursing facility/rehab facility | Network: $68 per day Non-network: $411 per day or 20% (whichever is less) |
TRICARE Young Adult
- Except for monthly premiums, all TRICARE Young Adult costs follow Group B costs, based on your plan option and sponsor’s status.
- “Network” means a provider in the TRICARE network. “Non-network” means a TRICARE-authorized provider not in the TRICARE network.
- Cost-shares are percentages of the TRICARE maximum-allowable charge after the annual deductible is met.
Costs for adult children of active duty sponsors and TRICARE Reserve Select enrollees
| Cost Type | TRICARE Young Adult-Prime Sponsor status: Active duty |
TRICARE Young Adult-Select Sponsor status: Active duty or TRS enrollee |
|---|---|---|
| Premium (monthly) | $893 per individual | $394 per individual |
| Deductible (annual) | $0 | Pay grades E-1 through E-4: $68 per individual Pay grades E-5 and above: $205 per individual |
| Catastrophic cap (annual) | $1,372 per family | $1,372 per family |
| Preventive care | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $0 |
| Outpatient visit — primary care | Network: $0 Non-network: Point-of-service fees |
Network: $20 Non-network: 20% |
| Outpatient visit — specialty care | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Urgent care | Network provider or TRICARE-authorized urgent care center: $0 Any other urgent care provider: Point-of-service fees |
Network: $27 Non-network: 20% |
| Emergency visit | Network or Non-network: $0 |
Network: $54 Non-network: 20% |
| Laboratory and X-ray services | Network: $0 Non-network: Point-of-service fees |
Network: $0 Non-network: 20% |
| Ambulatory surgery | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Ambulance | Network or non-network: $0 |
Outpatient (ground): Network: $20; Non-network: 20% Outpatient (air): 20% (network or non-network) Inpatient: 20% |
| Mental health — inpatient admission | Network: $0 Non-network: Point-of-service fees |
Network: $82 per admission Non-network: 20% |
| Mental health (outpatient care/partial hospitalization) — specialty care | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Mental health — residential treatment center | Network: $0 Non-network: Point-of-service fees |
Network: $34 per day Non-network: $68 per day |
| Durable medical equipment | Network: $0 Non-network: Point-of-service fees |
Network: 10% Non-network: 20% |
| Home healthcare | Network or non-network: $0 | Network or non-network: $0 |
| Hospice care | Network or non-network: $0 | Network or non-network: $0 |
| Hospitalization (inpatient admission) | Network: $0 Non-network: Point-of-service fees |
Network: $82 per admission Non-network: 20% |
| Maternity — hospital delivery | Network: $0 Non-network: Point-of-service fees |
Network: $82 per admission Non-network: 20% |
| Maternity — birthing center delivery | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Maternity — delivery at home (primary care) | Network: $0 Non-network: Point-of-service fees |
Network: $20 Non-network: 20% |
| Maternity — delivery at home (specialty care) | Network: $0 Non-network: Point-of-service fees |
Network: $34 Non-network: 20% |
| Inpatient skilled nursing facility/rehab facility | Network: $0 Non-network: Point-of-service fees |
Network: $34 per day Non-network: $68 per day |
Costs for adult children of retired sponsors and TRICARE Retired Reserve enrollees
| Cost Type | TRICARE Young Adult-Prime Sponsor status: Retired |
TRICARE Young Adult-Select Sponsor status: Retired or TRR enrollee |
|---|---|---|
| Premium (monthly) | $893 per individual | $394 per individual |
| Deductible (annual) | $0 | Network: $205 per individual Non-network: $411 per individual |
| Catastrophic cap (annual) | $4,802 per family | $4,802 per family |
| Preventive care | Network: $0 Non-network: Point-of-service fees |
Network or non-network: $0 |
| Outpatient visit — primary care | Network: $27 Non-network: Point-of-service fees |
Network: $34 Non-network: 25% |
| Outpatient visit — specialty care | Network: $41 Non-network: Point-of-service fees |
Network: $54 Non-network: 25% |
| Urgent care | Network provider or TRICARE-authorized urgent care center: $41 Any other urgent care provider: Point-of-service fees |
Network: $54 Non-network: 25% |
| Emergency visit | Network or non-network: $82 | Network: $109 Non-network: 25% |
| Laboratory and X-ray services | Network: $0 Non-network: Point-of-service fees |
Network: $0 Non-network: 25% |
| Ambulatory surgery | Network: $82 Non-network: Point-of-service fees |
Network: $130 Non-network: 25% |
| Ambulance | Outpatient (ground): $54 Outpatient (air): $20 Inpatient: 25% |
Outpatient (ground): Network: $82; Non-network: 25% Outpatient (air): 25% (network or non-network) Inpatient: 25% |
| Mental health — inpatient admission | Network or non-network: $205 per admission |
Network: $240 per admission Non-network: 25% |
| Mental health (outpatient care/partial hospitalization) — specialty care | Network: $41 Non-network: Point-of-service fees |
Network: $54 Non-network: 25% |
| Mental health — residential treatment center | Network: $41 per day Non-network: Point-of-service fees |
Network: $68 per day Non-network: $411 per day or 20% (whichever is less) |
| Durable medical equipment | Network: 20% Non-network: Point-of-service fees |
Network: 20% Non-network: 25% |
| Home healthcare | Network or non-network: $0 | Network or non-network: $0 |
| Hospice care |
Network or non-network: $0 |
Network or non-network: $0 |
| Hospitalization (inpatient admission) | Network or non-network: $205 per admission |
Network: $240 per admission Non-network: 25% |
| Maternity — hospital delivery | Network or non-network: $205 per admission |
Network: $240 per admission Non-network: 25% |
| Maternity — birthing center delivery | Network: $82 Non-network: Point-of-service fees |
Network: $130 Non-network: 25% |
| Maternity — delivery at home (primary care) | Network: $27 Non-network: Point-of-service fees |
Network: $34 Non-network: 25% |
| Maternity — delivery at home (specialty care) | Network: $41 Non-network: Point-of-service fees |
Network: $54 Non-network: 25% |
| Inpatient skilled nursing facility/rehab facility | Network: $41 per day Non-network: Point-of-service fees |
Network: $68 per day Non-network: $411 per day or 20% (whichever is less) |