Note: Visit our Copayment and Cost-Share Information page for 2021 costs.
TRICARE Reserve Select $47.20 $238.99 TRICARE Retired Reserve $484.83 $1,165.01 TRICARE Young Adult Prime $459 Not available TRICARE Young Adult Select $257 Not available When enrolled in a premium-based health plan (TRS, TRR, TYA Prime, TYA Select, or CHCBP), you pay a monthly or quarterly premium and follow Group B deductibles and applicable. Comparing TRICARE Prime And TRICARE Select. Under TRICARE Prime, the provider will file insurance claims for you in most cases. Under Select, network providers may file claims for you, but when getting non-network care, you may be required to file your. Tricare Select is a fee-for-service insurance plan that lets you see any doctor. This plan is available to family members, veterans, and retirees.
View the cost information below for retirees and their family members (not including TRICARE Young Adult) with sponsors who enlisted before Jan. 1, 2018.
| TRICARE Prime | TRICARE Select | |
|---|---|---|
| Enrollment Fees | $300/individual, $600/family (annually) | $0 |
| Annual Deductibles | $0 | $150/individual, $300/family |
| Catastrophic Cap | $3,000 per calendar year | $3,000 per calendar year |
Note:Point of Service cost-shares and deductibles may apply to TRICARE Prime and TRICARE Prime Remote beneficiaries.
Annual deductibles apply to outpatient services only.
| Type of Care | TRICARE Prime | TRICARE Select |
|---|---|---|
| Ambulance Services - Outpatient | $41 | Network Provider: $90 Non-Network Provider: 25% |
| Ambulatory Surgery | $62 | Network Provider: 20% Non-Network Provider: 25% |
| Ancillary Services | $0 | Network Provider: $0 Non-Network Provider: 25% |
| Durable Medical Equipment | 20% | Network Provider: 20% Non-Network Provider: 25% |
| Emergency Room | $62 | Network Provider: $118 Non-Network Provider: 25% |
| Home Health Care | $0* | $0* |
| Hospice Care | $0 | $0 |
| Hospitalization - Physical Health | $156 per admission | Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: Lesser of $1,035 per day or 25%, plus 25% of professional fees |
| Hospitalization - Mental Health | $156 per admission | Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: 25% |
| Laboratory and X-Rays | $0 | Network Provider: $0 Non-Network Provider: 25% |
| Maternity Care - Inpatient Delivery Setting | $156 per admission | Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: Lesser of $1,035 per day or 25%, plus 25% of professional fees |
| Office Visits - Primary Care | $20 | Network Provider: $30 Non-Network Provider: 25% |
| Office Visits - Specialty Care | $31 | Network Provider: $45 Non-Network Provider: 25% |
| Outpatient Mental Health Visits | $31 | Network Provider: $45 Non-Network Provider: 25% |
| Partial Hospitalization | $31 per day** | Network Provider: $45** Non-Network Provider: 25% |
| Preventive Services - Eye Examinations | $0 | Not a covered benefit |
| Preventive Services - All Other Covered Services | $0 | $0 |
| Residential Treatment Center | $31 per day | Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: 25% of allowable charges |
| Skilled Nursing Facility | $31 per day | Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: 25% of allowable charges |
| Urgent Care Services | $31 | Network Provider: $30 Non-Network Provider: 25% |
*Costs may apply for durable medical equipment (DME) and medications/drugs.
**Copayment information is calculated per day for partial hospitalization programs and intensive outpatient treatment. Opioid treatment program services copayment is applied on a weekly basis.
Annual deductibles apply to network and non-network providers for outpatient services only.
- Deductibles must be met before TRICARE benefits are payable.
- Once the deductible is met, cost-shares apply.
- Network providers can collect at a minimum the copayment at the time of service. A provider may also collect the outstanding balance of the deductible. The explanation of benefits (EOB) will inform the beneficiary and provider of the allowed amount and patient responsibility.
- Deductibles apply to the catastrophic cap.
- TRICARE Select, TRICARE Young Adult Select, TRICARE Reserve Select, and TRICARE Retired Reserve deductibles do not apply to preventive services.
- Exception: Deductibles will apply to routine eye examinations (when covered), school physicals and assignment-ordered physicals, when performed by non-network providers.
A beneficiary's deductible is determined by the sponsor's initial enlistment or appointment date:
- Group A: Sponsor's enlistment or appointment date occurred prior to Jan. 1, 2018.
- Group B: Sponsor's enlistment or appointment date occurred on or after Jan. 1, 2018.
TRICARE Prime and TRICARE Prime Remote (not including TRICARE Young Adult)
| Active Duty Family Members | Retirees and Their Family Members |
|---|---|
Group A: $0 Group B: $0 Point of Service deductibles are calculated separately. | Group A: $0 Group B: $0 Point of Service deductibles are calculated separately. |
TRICARE Select (not including TRICARE Young Adult)
| Active Duty Family Members | Retirees and Their Family Members |
|---|---|
Group A: Group B: 2020: E4 and Below: $52/individual, $104/family 2021: E4 and Below: $52/individual, $105/family | Group A: Group B: 2020: Network Providers: $156/individual, $313/family 2021: Network Providers: $158/individual, $317/family |
TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)
| TRICARE Reserve Select (TRS) | TRICARE Retired Reserve (TRR) |
|---|---|
2020: E4 and Below: $52/individual, $104/family 2021: E4 and Below: $52/individual, $105/family | 2020: Network Providers: $156/individual, $313/family 2021: Network Providers: $158/individual, $317/family |
TRICARE Young Adult
The TRICARE Young Adult deductible is based on the sponsor's status.
Tricare Prime Cost 2021
| TRICARE Prime | TRICARE Select | ||
|---|---|---|---|
| Active Duty Family Members | Retiree Family Members | Active Duty Family Members | Retiree Family Members |
| $0 | $0 | 2020: 2021: | 2020: 2021: |