Copayments & Cost-Shares

  • Most costs are for calendar year 2020

  • Active duty service members pay nothing out-of-pocket for any type of care

  • Active duty family members only pay for care when they use:

    • A network pharmacy or TRICARE Home Delivery

    • A TRICARE Prime plan and they get care without a referral1

    • TRICARE Select

  • There is no cost for services received at an MTF except for a small per diem when using inpatient care
  • For US Family Health Plan and TRICARE Prime Remote costs, choose "TRICARE Prime" from the pull-down menu
  • You only have to pay the TRICARE For Life (TFL) Health Plan Costs listed if a service is covered by TRICARE and not by Medicare. If you are looking for Medicare and TRICARE covered service costs, download the TFL Cost Matrix.
  • Visit the Cost Terms page for definitions to help you better understand TRICARE costs.
  • If you're an unremarried former spouse, for the Continued Health Care Benefit Program (CHCBP), chose "Retired" regardless of your sponsor's status 

1TRICARE Prime includes a point-of-service option. This means you pay higher costs when you don't have a referral or you use non-network providers without authorization from the TRICARE regional contractor. If you have a referral and/or authorization, your costs are the same as network costs.

Note: The point-of-service option isn't available to active duty service members.

 

When did the sponsor enter uniformed service?
Did you get tested for COVID19?

Copayments will be waived retroactively to March 18 for certain testing and office visits related to the testing. The test must be one approved, cleared, or authorized by the Food and Drug Administration to detect SARS-CoV-2 or diagnose COVID-19. If you paid any copayments for testing related to COVID-19 and the resulting office visits with a network or non- network provider, you may file a claim for reimbursement. For more information related to the coronavirus, visit the FAQ page.

Last Updated 3/3/2020