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 three TRICARE options.
The listed fees are subject to change each year. Contact your local Health Benefits Advisor (HBAs) - located at your local Military Treatment Facilities (MTFs) - or beneficiary counseling and assistance coordinator (BCAC) for answers to any questions about coverage, co-payments and cost shares.
Cost shares and deductibles for Active Duty, Guard and Reserve Family Members:
TRICARE Prime |
TRICARE Select |
|
| Annual Deductible | None |
$150/individual or $300/family for E-5 & above; $50/$100 for E-4 & below |
| Annual Enrollment Fee | None | None |
| Outpatient Visit | No cost |
$21 Primary Care $31 Specialist 20% out-of-network |
| Hospital Admission | No cost | $18.60/day |
| Emergency Room | No cost |
$81 network 20% out-of-network |
| Maternity Care | $0 per diem charge per admission No separate co-payment/cost-share for separately billed professional charges |
$18.60/day in the hospital $25 for in-network authorized birthing facility
|
Cost Shares for Retirees (under 65), Their Family Members, and Others:
TRICARE Prime |
TRICARE Select |
|
| Annual Deductible | None | $150/individual or $300/family |
| Annual Enrollment Fee | $298.08/individual $578.16/family | None |
| Doctor Visit |
$20 Primary Care $30 Specialist |
$28 Primary Care $41 Specialist $25% out-of-network |
| Ambulance | $40 |
$98 network 25% out-of-network |
| Emergency Room | $60 |
$109 network 25% out-of network |
| Hospital | $150 |
Network: 25% of hospital charge ($250 daily max) plus 20% of separately billed services Out-of-network: 25% of hospital charge ($901 daily max) plus 25% of separately billed services |
For more detailed information see our detailed TRICARE program pages:
