Copayments & Cost-Shares
Costs are for calendar year 2025, unless noted separately.
Looking for 2024 TRICARE Health Plan costs? View the 2024 TRICARE Health Plan costs article to learn more.
This is a general overview of most costs and fees for TRICARE. Check out the TRICARE Plan Finder to learn more about eligibility and TRICARE plans.
Looking for a printable version of these costs? Check out the 2025 TRICARE Costs and Fees Fact Sheet.
Know Your Beneficiary Group
Your beneficiary category and your beneficiary group determine the enrollment fees or premiums and out-of-pocket costs for your TRICARE plan. TRICARE beneficiaries fall into one of two groups:
- Group AIf you or your sponsor’s initial enlistment or appointment occurred before January 1, 2018, you are in Group A.: Your or your sponsor’s initial enlistment or appointment began before Jan. 1, 2018.
- Group BIf you or your sponsor’s initial enlistment or appointment occurs on or after January 1, 2018, are in Group B.: Your or your sponsor’s initial enlistment or appointment began on or after Jan. 1, 2018.
Below are the lists of the calendar year 2025 costs for TRICARE health plans.
Notes:
- “Network” means a provider in the TRICARE network. “Out-of-network” means a TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS not in the TRICARE network.
- Percentages are percentages of the TRICARE maximum-allowable chargeThe maximum amount TRICARE pays for each procedure or service. This is tied by law to Medicare's allowable charges. after annual deductible is met.
TRICARE Prime costs (including US Family Health Plan)
Active duty service members don’t have out-of-pocket costs; however, active duty family members and transitional survivors may. If you’re enrolled in a TRICARE Prime plan, you won’t have copayments unless you use the point-of-service option or fill a prescription outside of a military pharmacy.
|
Cost Type |
TRICARE Prime |
TRICARE Prime |
|
Covered Services |
$0 |
$0 |
|
AnnualCatastrophic Cap |
$1,000 per family |
$1,288 per family |
|
Cost Type |
TRICARE Prime |
TRICARE Prime |
|
Annual Enrollment Fee |
Individual: $372* Family: $744* |
Individual: $450 Family: $900.96 |
|
Annual Deductible |
$0 |
$0 |
|
Annual Catastrophic Cap |
$3,000 per family |
$4,509 per family |
|
Clinical Preventive Services |
$0 |
$0 |
|
Outpatient Visit – Primary |
Network: $25 Out-of-Network: POS |
Network: $25 Out-of-Network: POS |
|
Outpatient Visit – Specialty |
Network: $38 Out-of-Network: POS |
Network: $38 Out-of-Network: POS |
|
Urgent Care |
TRICARE-authorized urgent care provider: $38 Any other urgent care provider: POS |
TRICARE-authorized urgent care provider: $38 Any other urgent care provider: POS |
|
Emergency Services |
$77 |
$77 |
|
Laboratory and X-ray |
Network: $0 Out-of-Network: POS |
Network: $0 Out-of-Network: POS |
|
Ambulatory Surgery |
Network: $77 Out-of-Network: POS |
Network: $77 Out-of-Network: POS |
|
Ambulance |
Outpatient (Air): $20 Inpatient: 25% of allowable charge |
Inpatient: 25% of allowable charge |
|
Mental Health (Inpatient) |
Network: $193 per admission Out-of-Network: POS |
Network: $193 per admission Out-of-Network: POS |
|
Mental Health (Outpatient/Partial Hospitalization) – Primary Care |
Network: $25 Out-of-Network: POS |
Network: $25 Out-of-Network: POS |
|
Mental Health (Outpatient/Partial Hospitalization) – Specialty Care |
Network: $38 Out-of-Network: POS |
Network: $38 Out-of-Network: POS |
|
Mental Health (Residential Treatment Facility) |
Network: $38 per day Out-of-Network: POS |
Network: $38 per day Out-of-Network: POS |
|
Durable Medical Equipment |
Network: 20% Out-of-Network: POS |
Network: 20% Out-of-Network: POS |
|
Home Health Care |
Network: $0 Out-of-Network: POS |
Network: $0 Out-of-Network: POS |
|
Hospice Care |
Network: $0 (Medical equipment and pharmacy are billed separately.) Out-of-Network: POS |
Network: $0 (Medical equipment and pharmacy are billed separately.) Out-of-Network: POS |
|
Hospitalization (Inpatient Care) |
$193 per admission |
$193 per admission |
|
Immunizations |
Network: $0 Out-of-Network: POS |
Network: $0 Out-of-Network: POS |
|
Maternity (Delivery/Inpatient) |
Network: $193 per admission Out-of-Network: POS |
Network: $193 per admission Out-of-Network: POS |
|
Maternity (Delivery/Birthing Center) |
Network: $77 Out-of-Network: POS |
Network: $77 Out-of-Network: POS |
|
Maternity (Home) – Primary |
Network: $25 Out-of-Network: POS |
Network: $25 Out-of-Network: POS |
|
Maternity (Home) – Specialty |
Network: $38 Out-of-Network: POS |
Network: $38 Out-of-Network: POS |
|
Newborn Care |
Network: $0 Out-of-Network: POS |
Network: $0 Out-of-Network: POS |
|
Inpatient Skilled Nursing Facility/Rehab Facility |
Network: $38 per day Out-of-Network: POS |
Network: $38 per day Out-of-Network: POS |
*Note: These costs are for calendar year 2025. Enrollment fees may differ for certain beneficiaries in Group A; see section below for more information.
For medically retired sponsors, their family members, and survivors in Group A, their enrollment fee remains frozen at the rate when the survivor or medically retired member is classified in the Defense Enrollment Eligibility Reporting System in either category and enrolls, as long as there is a continuous TRICARE Prime enrollment. For other costs, see TRICARE Prime costs for retirees.
|
Date of Classification in DEERS |
Annual Enrollment Fee |
|
After Jan. 1, 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 Select costs
|
Cost Type |
TRICARE Select |
TRICARE Select |
|
Annual Deductible |
E-1–E-4: $50 per individual and $100 per family E-5 & above: $150 per individual and $300 per family |
E-1–E-4: $64 per individual and $128 per family E-5 & above: $193 per individual and $386 per family |
|
Annual Catastrophic Cap |
$1,000 per family |
$1,288 per family |
|
Clinical Preventive Services |
$0 |
$0 |
|
Outpatient Visit – Primary |
Network: $27 Out-of-Network: 20% |
Network: $19 Out-of-Network: 20% |
|
Outpatient Visit – Specialty |
Network: $38 Out-of-Network: 20% |
Network: $32 Out-of-Network: 20% |
|
Urgent Care |
Network: $27 Out-of-Network: 20% |
Network: $25 Out-of-Network: 20% |
|
Emergency Services |
Network: $105 Out-of-Network: 20% |
Network: $51 Out-of-Network: 20% |
|
Laboratory and X-ray |
Network: $0 Out-of-Network: 20% |
Network: $0 Out-of-Network: 20% |
|
Ambulatory Surgery |
Network and Out-of-Network: $25 |
Network: $32 Out-of-Network: 20% |
|
Ambulance |
Outpatient (Air): 20% (Network or Out-of-Network) Inpatient: 20% |
Outpatient (Air): 20% (Network or Out- of-Network) Inpatient: 20% |
|
Mental Health (Inpatient) |
Network and Out-of-Network: $23.45 per day or $25 per admission (whichever is more) |
Network: $77 per admission Out-of-Network: 20% |
|
Mental Health (Outpatient/Partial Hospitalization) – Primary Care |
Network: $27 Out-of-Network: 20% |
Network: $19 Out-of-Network: 20% |
|
Mental Health (Outpatient/Partial Hospitalization) – Specialty Care |
Network: $38 Out-of-Network: 20% |
Network: $32 Out-of-Network: 20% |
|
Mental Health (Residential Treatment Facility) |
Network and Out-of-Network: $23.45 per day or $25 per admission (whichever is more) |
Network: $32 per admission Out-of-Network: $64 per admission |
|
Durable Medical Equipment |
Network: 15% Out-of-Network: 20% |
Network: 10% Out-of-Network: 20% |
|
Home Health Care |
Network: $0 |
Network: $0 |
|
Hospice Care |
Network: $0 (Medical equipment and pharmacy are billed separately.) |
Network: $0 (Medical equipment and pharmacy are billed separately.) |
|
Hospitalization (Inpatient Care) |
Network and Out-of-Network: $23.45 per day or $25 per admission (whichever is more) |
Network: $77 per admission Out-of-Network: 20% |
|
Immunizations |
$0 |
$0 |
|
Maternity (Delivery/Inpatient) |
Network and Out-of-Network: $23.45 per day or $25 per admission (whichever is more) |
Network: $77 per admission Out-of-Network: 20% |
|
Maternity (Delivery/Birthing Center) |
Network and Out-of-Network: $25 |
Network: $32 Out-of-Network: 20% |
|
Maternity (Home) – Primary |
Network: $27 Out-of-Network: 20% |
Network: $19 Out-of-Network: 20% |
|
Maternity (Home) – Specialty |
Network: $38 Out-of-Network: 20% |
Network: $32 Out-of-Network: 20% |
|
Newborn Care |
$0 |
Network: $0 Out-of-Network: 20% |
|
Inpatient Skilled Nursing Facility/Rehab Facility |
Network and Out-of-Network: $23.45 per day or $25 per admission (whichever is more) |
Network: $32 per admission Out-of-Network: $64 per admission |
|
Cost Type |
TRICARE Select |
TRICARE Select |
|
Annual Enrollment Fee |
Individual: $181.92 Family: $364.92 |
Individual: $579 Family: $1,158.96 |
|
Annual Deductible |
Individual: $150 Family: $300 |
Individual: $193 (Network); $386 (Out-of- Network) Family: $386 (Network); $772 (Out-of- Network) Note: Prescription costs also apply to your annual deductible. |
|
Annual Catastrophic Cap |
$4,261 per family |
$4,509 per family |
|
Clinical Preventive Services |
$0 |
$0 |
|
Outpatient Visit – Primary |
Network: $37 Out-of-Network: 25% |
Network: $32 Out-of-Network: 25% |
|
Outpatient Visit – Specialty |
Network: $51 Out-of-Network: 25% |
Network: $51 Out-of-Network: 25% |
|
Urgent Care |
Network: $37 Out-of-Network: 25% |
Network: $51 Out-of-Network: 25% |
|
Emergency Services |
Network: $140 Out-of-Network: 25% |
Network: $103 Out-of-Network: 25% |
|
Laboratory and X-ray |
Network: $0 Out-of-Network: 25% |
Network: $0 Out-of-Network: 25% |
|
Ambulatory Surgery |
Network: 20% Out-of-Network: 25% |
Network: $122 Out-of-Network: 25% |
|
Ambulance |
Outpatient (Air): 25% (Network or Out-of-Network) Inpatient: 25% |
Outpatient (Air): 25% (Network or Out- of-Network) Inpatient: 25% |
These costs also apply to medical retirees, their family members, and survivors, besides the exceptions noted for Group A below.
|
Cost Type |
TRICARE Select |
TRICARE Select |
|
Mental Health (Inpatient) |
Network: $250 per day or up to 25% hospital charge (whichever is less); plus 20% separately billed services Out-of-Network: $1,306 per day§ or up to 25% hospital charge (whichever is less); plus 25% separately billed services |
Network: $225/admission Out-of-Network: 25% |
|
Mental Health (Outpatient/Partial Hospitalization) - Primary Care |
Network: $37 Out-of-Network: 25% |
Network: $32 Out-of-Network: 25% |
|
Mental Health (Outpatient/Partial Hospitalization) - Specialty Care |
Network: $51 Out-of-Network: 25% |
Network: $51 Out-of-Network: 25% |
|
Mental Health (RTF) |
Network: $250 per day or up to 25% hospital charge (whichever is less); plus 20% separately billed services Out-of-Network: 25% |
Network: $64 per day Out-of-Network: Lesser of $386 per day or 20% |
|
Durable Medical Equipment |
Network: 20% Out-of-Network: 25% |
Network: 20% Out-of-Network: 25% |
|
Home Health Care |
Network: $0 |
Network: $0 |
|
Hospice Care |
Network: $0 (Medical equipment and pharmacy are billed separately) |
Network: $0 (Medical equipment and pharmacy are billed separately) |
|
Hospitalization (Inpatient Care) |
Network: $250 per day or up to 25% hospital charge (whichever is less); plus 20% separately billed services Out-of-Network: $1,306 per day§ or up to 25% hospital charge (whichever is less); plus 25% separately billed services |
Network: $225 per admission Out-of-Network: 25% |
|
Immunizations |
$0 |
$0 |
|
Maternity (Delivery/Inpatient) |
Network: $250 per day or up to 25% hospital charge (whichever is less); plus 20% separately billed services Out-of-Network: $1,306 per day§ or up to 25% hospital charge (whichever is less); plus 25% separately billed services |
Network: $225 per admission Out-of-Network: 25% |
|
Maternity (Delivery/Birthing Center) |
Network: 20% Out-of-Network: 25% |
Network: $122 Out-of-Network: 25% |
|
Maternity (Home) - Primary |
Network: $37 Out-of-Network: 25% |
Network: $32 Out-of-Network: 25% |
|
Maternity (Home) - Specialty |
Network: $51 Out-of-Network: 25% |
Network: $51 Out-of-Network: 25% |
|
Newborn Care |
$0 |
Network: $0 Out-of-Network: 20% |
|
Inpatient Skilled Nursing Facility/Rehab Facility |
Network: $250 per day or up to 25% hospital charge (whichever is less); plus 20% separately billed services Out-of-Network: 25% |
Network: $64 per day Out-of-Network: Lesser of $386 per day or 20% |
§ 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.
|
Cost Type |
TRICARE Select – Medically Retired |
|
Annual Enrollment Fee |
$0 |
|
Annual Catastrophic Cap |
$3,000 per family |
For all other costs, Group A costs apply to medically retired Group A TRICARE Select enrollees and their family members.
TRICARE Reserve Select and TRICARE Retired Reserve costs
Follow TRICARE Select Group B costs based on your sponsor’s status, except for the following costs:
|
Cost Type |
TRICARE Reserve Select |
TRICARE Retired Reserve |
|
Premium |
Member only: $53.80 per month Member and family: $274.48 per month |
Member only: $631.26 per month Member and family: $1,513.04 per month |
|
Deductible |
E1-E4: $64 per individual and $128 per family E-5 & above: $193 per individual and $386 per family Note: Prescription costs also apply to your annual deductible. |
Network: $193 per individual and $386 per family Out-of-Network: $386 per individual and $772 per family Note: Prescription costs also apply to your annual deductible. |
|
Annual Catastrophic Cap |
$1,288 |
$4,509 |
TRICARE Young Adult costs
Follow TRICARE Prime Group B costs based on your sponsor’s status, except for the following premium:
|
Cost Type |
Individual |
|
Monthly Premium |
$727 |
Follow TRICARE Select Group B costs based on your sponsor’s status, except for the following premium:
|
Cost Type |
Individual |
|
Monthly Premium |
$337 |
Continued Health Care Benefit Program costs
Follow TRICARE Select Group B costs based on your sponsor’s status, except for the following premium:
|
Cost Type |
Individual |
Family |
|
Quarterly Premium |
$1,849 |
$4,621 |
TRICARE For Life costs
Check out the TRICARE For Life Cost Matrix. This fact sheet shows what Medicare pays for services covered by Medicare and TRICARE.
TRICARE Pharmacy Program costs
Note: Copayments won’t change in 2025 for survivors of active duty service members and medically retired service members and their family members.
|
Pharmacy Type |
Generic Formulary Drug Costs |
Brand-Name Formulary Drug Costs |
Non-Formulary Drug Costs |
Non-Covered Drug Costs |
|
Military Pharmacy Up to a 90-day supply |
$0 |
$0 |
Generally not available without medical necessity |
Not available |
|
TRICARE Pharmacy Home Delivery Up to a 90-day supply |
$13 |
$38 |
$76 |
Not available |
|
TRICARE Retail Network Pharmacy Up to a 30-day supply |
$16 |
$43 |
$76 |
Full cost of drug |
|
Non-network Retail Pharmacy (in the U.S. and U.S. territories: American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands) |
TRICARE Prime options: 50% cost-share applies after you meet your point-of-service annual deductible
All other beneficiaries: You pay for formulary drugs ($43 or 20% of total cost, whichever is more, after you meet your annual deductible) and non- formulary drugs ($76 or 20% of total cost, whichever is more, after you meet your annual deductible). |
Full cost of drug |
||
|
Overseas Pharmacy (outside the U.S. and U.S. territories)
Visit www.tricare.mil/pharmacy for more information. |
ADSMs and ADFMs using TRICARE Prime Overseas or TRICARE Prime Remote Overseas: $0 (you may have to pay the full cost up front and file a claim for reimbursement)
ADFMs using TRICARE Select Overseas and TRS members: 20% cost-share after you meet your annual deductible
Retirees, their family members, TRR members, and all others in TRICARE Select Overseas: 25% cost- share after you meet your annual deductible |
Full cost of drug |
||
|
Pharmacy Type |
Generic Formulary Drug Costs |
Brand-Name Formulary Drug Costs |
Non-Formulary Drug Costs |
Non-Covered Drug Costs |
|
Military Pharmacy Up to a 90-day supply |
$0 |
$0 |
Generally not available without medical necessity |
Not available |
|
TRICARE Pharmacy Home Delivery Up to a 90-day supply |
$0 |
$20 |
Network: $49 |
Not available |
|
TRICARE Retail Network Pharmacy Up to a 30-day supply |
Network: $10 Out-of-Network: 50% after POS |
Network: $24 Out-of-Network: 50% after POS |
Network: $50 Out-of-Network: $50 or 20% of total cost, whichever is more |
Full cost of drug |
|
Non-network Retail Pharmacy (in the U.S. and U.S. territories: American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands) |
50% cost-share applies after you meet your point-of- service annual deductible
|
Full cost of drug |
||
|
Overseas Pharmacy (outside the U.S. and U.S. territories)
Visit www.tricare.mil/pharmacy for more information. |
Retirees, their family members, TRR members, and all others in TRICARE Select Overseas: 25% cost- share after you meet your annual deductible |
Full cost of drug |
||
|
Pharmacy Type |
Generic Formulary Drug Costs |
Brand-Name Formulary Drug Costs |
Non-Formulary Drug Costs |
Non-Covered Drug Costs |
|
Military Pharmacy Up to a 90-day supply |
$0 |
$0 |
Generally not available without medical necessity |
Not available |
|
TRICARE Pharmacy Home Delivery Up to a 90-day supply |
$0 |
$20 |
Network: $49 |
Not available |
|
TRICARE Retail Network Pharmacy Up to a 30-day supply |
Network: $10 Out-of-Network: $24 or 20% of total cost, whichever is more |
Network: $24 Out-of-Network: $24 or 20% of total cost, whichever is more |
Network: $50 Out-of-Network: $50 or 20% of total cost, whichever is more |
Full cost of drug |
|
Non-network Retail Pharmacy (in the U.S. and U.S. territories: American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands) |
You pay for formulary drugs and non-formulary drugs. |
Full cost of drug |
||
|
Overseas Pharmacy (outside the U.S. and U.S. territories)
Visit www.tricare.mil/pharmacy for more information. |
Retirees, their family members, TRR members, and all others in TRICARE Select Overseas: 25% cost- share after you meet your annual deductible |
Full cost of drug |
||
Visit Cost Terms to learn about common healthcare terms and what they mean. You can also check out dental costs (in effect through Feb. 28, 2025).
Last Updated 1/10/2025