TRICARE Cost Co-Pay Schedule

Doctor checking piggy bank with stethoscope

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:

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