Proposed TRICARE Fee Changes
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: |
$460/$520 |
$600 |
$680 |
$760 |
$850 |
$893 |
|
Tier 2: |
$460/$520 |
$720 |
$920 |
$1,185 |
$1,450 |
$1,523 |
|
Tier 3: |
$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 |
|
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|
Annual Deductibles |
|
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|
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 |
$35 |
$75 |
$115 |
$150 |
$158 |
|
Tier 2: |
$0 |
$75 |
$150 |
$225 |
$300 |
$317 |
|
Tier 3: |
$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 |
|
|
|
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|
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 |
|
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|
Military Treatment Facilities |
No Change – Remains $0 Co-Pay |
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* Non-Formulary pharmaceuticals will have limited availability in retail pharmacies
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