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headerLegislativeCenter

Legislative Center

Border Jobs for Veterans Act

H.R. 2835

Proposed TRICARE Fee Changes

TRICARE Pharmacy Costs

Proposed Changes to TRICARE Fees

The following tables reflect the proposed changes to TRICARE fees, deductibles, and co-pays for Fiscal Year 2013 through 2017. The enrollment fees and deductible changes would affect military retirees only. The changes to TRICARE Pharmacy co-pays would affect all TRICARE beneficiaries.

Proposed TRICARE Prime Annual Family Enrollment Fees (Individual Fees are 50%) for Working-Age Retirees


Retired Pay Tiers

FY 2012

FY 2013

FY 2014

FY 2015

FY 2016*

FY 2017

Tier 1:
$0 – $22,589

$460/$520

$600

$680

$760

$850

$893

Tier 2:
$22,590 – $45,178

$460/$520

$720

$920

$1,185

$1,450

$1,523

Tier 3:
Over $45,178

$460/$520

$820

$1,120

$1,535

$1,950

$2,048

*Indexed to medical inflation (National Health Expenditures) after FY 2016.

Proposed TRICARE Standard/Extra Fees/Deductibles for Working-Age Retirees


Annual Enrollment Fees

FY 2012

FY 2013

FY 2014

FY 2015

FY 2016

FY 2017*

Individual

$0

$70

$85

$100

$115

$130

Family

$0

$140

$170

$200

$230

$250

 

Annual Deductibles

 

Individual

$150

$160

$200

$230

$260

$290

Family

$300

$320

$400

$460

$520

$580

*Indexed to medical inflation (National Health Expenditures) after FY 2017.

Proposed TRICARE-for-Life  (TFL) Annual Enrollment Fees – Per Individual


Retired Pay Tiers

FY 2012

FY 2013

FY 2014

FY 2015

FY 2016*

FY 2017

Tier 1:
$0 – $22,589

$0

$35

$75

$115

$150

$158

Tier 2:
$22,590 – $45,178

$0

$75

$150

$225

$300

$317

Tier 3:
Over $45,178

$0

$115

$225

$335

$450

$475

*Indexed to medical inflation (National Health Expenditures) after FY 2016.

 

Proposed Pharmacy Co-Pays for All TRICARE Beneficiaries


RX Source

FY 2012

FY 2013

FY 2014

FY 2015

FY 2016

FY 2017

Retail – 1 month fill

 

Generic

$5

$5

$6

$7

$8

$9

Brand Name

$12

$26

$28

$30

$32

$34

Non-Formulary*

$25

N/A

N/A

N/A

N/A

N/A

 

 

Mail-Order – 3 month fill

 

 

 

 

 

 

Generic

$0

$0

$0

$0

$0

$9

Brand

$9

$26

$28

$30

$32

$34

Non-Formulary

$25

$51

$54

$58

$62

$66

 

Military Treatment Facilities

No Change – Remains $0 Co-Pay

* Non-Formulary pharmaceuticals will have limited availability in retail pharmacies

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