Mental Health Costs | TRICARE

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Mental Health Costs

Your mental health care costs are based on:

  • Who you are
  • Your health plan
  • The type of care – outpatient, partial hospitalization or inpatient 
Who You Are:  Your Plan:  Annual Deductible  Outpatient  Partial Hospitalization  Inpatient 
1Active duty service member TRICARE Prime plansTRICARE Prime plans include: TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas and TRICARE Young Adult-Prime  $0 $0 $0 $0
2Active duty family member TRICARE Prime plans $04 $0 $0 $0 
TRICARE Standard PlansTRICARE Standard Plans include: TRICARE Standard and Extra, TRICARE Standard Overseas and TRICARE Young Adult-Standard  E4 & below:
$50 per individual, but no more than $100 per family

E5 & above:
$150 per individual, but no more than $300 per family 
Network:
15% of negotiated feeThe discounted rate network providers agree to accept for covered services.

Non-network:
20% of allowable chargeThe maximum amount TRICARE pays for each procedure or service.  This is tied by law to Medicare's allowable charges.
Network: 
15% of negotiated fee

Non-network:
20% of allowable charge
$18.60 per day
($25 minimum charge)
3Retired service members, families & others TRICARE Prime plans $04
$12 per visit $12 per visit $11 per day
($25 minimum charge)
TRICARE Standard plans $150 per individual; no more than $300 per family Network:
20% of negotiated fee

Non-network:
25% of allowable charge
Network:
20% of negotiated fee

Non-network:
25% of allowable charge 
Network:
20% of the total +  20% for separately billed services

Non-network:
High Volume Hospitals: 25% hospital specific per diem + 25% for separately billed services

Low Volume Hospitals: $235 per day or 25% of the billed charges, whichever is less + 25% for separately billed services

Residential Treatment Centers: 25% of the allowed amount
Guard/Reserve members & their families TRICARE Reserve Select  E4 & below: 
$50 per individual, but no more than $100 per family 

E5 & above: 
$150 per individual, but no more than $300 per family 
Network: 
15% of negotiated fee

Non-network:
20% of allowable charge 
Network: 
15% of negotiated fee

Non-network:
20% of allowable charge
$18.60 per day 
($25 minimum charge)
TRICARE Retired Reserve $150 per individual; no more than $300 per family  Network:
20% of negotiated fee

Non-network:
25% of allowable charge
Network:
20% of negotiated fee

Non-network:
25% of allowable charge
Network:
20% of the total + 20% for separately billed services

Non-network:
High Volume Hospitals: 25% hospital specific per diem + 25% for separately billed services

Low Volume Hospitals: $235 per day or 25% of the billed charges, whichever is less + 25% for separately billed services

Residential Treatment Centers: 25% of the allowed amount 
  1. Includes activatedCalled or ordered to active duty service for more than 30 days in a row. Guard/Reserve members
  2. Includes family members of activated Guard/Reserve members
  3. Includes retired Guard/Reserve members and their families
  4. Annual deductible for TRICARE Prime is $0 unless using the point-of service option

Last Updated 10/25/2017