Tricare Cost Co-Pay Schedule

FacebookTwitterPinterestEmailEmailEmailShare
An obstetrician confers with a female patient.
An obstetrician confers with a patient Feb. 5, 2019. (U.S. Navy/Mass Communication Specialist 1st Class Brannon Deugan)

The following tables provide examples of cost shares or copayments and annual deductibles for families who use civilian providers and facilities under each of the Tricare options.

Tricare Categories

There are two separate categories of Tricare beneficiaries:

  1. Group A for service members who entered active duty before 2018
  2. Group B for service members who entered active duty in 2018 or later

Cost Shares and Deductibles for Active-Duty, Guard and Reserve Family Members:

 

Tricare Prime

Tricare Select

Annual Deductible None

Group A:

$50/individual or $100/family for E-4 and below;
$150/$300 for E-5 and above


Group B:

$62/individual or $125/family for E-4 and below;
$188/$377 for E-5 and above

Annual Enrollment Fee None None
Primary Care Visit No cost

Group A: $27
Group B: $18

Specialist No cost Group A: $38
Group B: $31
Ambulance No cost Group A: $79
Group B: $18
Emergency Room No cost

Group A: $104
Group B: $50

Hospital No cost

Group A: $22.30/day
Group B: $31/day in-network; $62/day out-of-network

Cost Shares for Retirees (under 65), Their Family Members, and Others:

 

Tricare Prime

Tricare Select

Annual Deductible None

Group A:

$150/individual; $300/family

Group B:

$188/individual; $377/family

Annual Enrollment Fee

Group A:

$363/individual
$726/family

Group B:

$438.96/individual
$879/family

Group A:

$177.96/individual
$355.92/family

Group B:

$564.96/individual
$1,131/family

Primary Care Visit

$25

Group A: $36
Group B: $31

Specialist $37 Group A: $50
Group B: $50
Ambulance $50

Group A: $106
Group B: $75

Emergency Room $75

Group A: $139
Group B: $100

Hospital $188/day

Group A: $250/day up to 25% of hospital charges, plus 20% of separately billed services
Group B: $219 per admission

For more detailed information see our detailed Tricare program pages:

Keep Up with Changes to Tricare and Your Other Benefits

Want to know about changes in military benefits as they happen? Subscribe to Military.com to get the latest benefits news delivered directly straight to your inbox.

Story Continues
Tricare