Tricare Copay 2020
Note: Visit our Copayment and Cost-Share Information page for 2021 costs.
2020 Group A Group B; Active Duty Family Members (TRICARE Prime and Select) $1,000 per family, per calendar year: $1,044 per family, per calendar year.
Visit the TRICARE Select Enrollment Fees page on the TRICARE website for updates and sign up for email alerts. TRICARE will inform you of specific actions you need to take in the coming months. Take command of your health and your health care benefits in 2020. Telemedicine copayment waiver: TRICARE is waiving copayments and cost-shares for covered audio-only or audio/video telemedicine rendered by network providers on or after May 12, 2020. This waiver applies to covered in-network telehealth services, not just services related to COVID-19.
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 |
Tricare Copays 2020
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. Andy os mac download.
**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.
Coronavirus (COVID-19) Update:
Providers are expected to refund cost-sharing amounts to beneficiaries as appropriate. |
- TRICARE Select, TRICARE Young Adult Select, TRICARE Reserve Select, and TRICARE Retired Reserve annual deductibles apply.
- TRICARE Young Adult costs are based on the sponsor's status.
- TRICARE Prime and TRICARE Young Adult Prime retirees have a separate copayment for allergy shots performed on a different day than the office visit, or performed by a different provider, such as an independent laboratory or radiology facility (even if performed on the same day as the related office visit).
- Transitional Assistance Management Program (TAMP) beneficiaries (service members and their family members) follow the active duty family member copayment/cost-share information, based on the TRICARE plan type.
A beneficiary's cost 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 For Life Cost 2020
TRICARE Prime and TRICARE Prime Remote (not including TRICARE Young Adult)
| Service | Active Duty Family Members | Retirees and Their Family Members |
|---|---|---|
| Primary Care Outpatient Office Visits | Group A: $0 Group B: $0 | Group A: $21 Group B: $21 |
Specialty Care Outpatient (this includes physical, occupational | Group A: $0 Group B: $0 | Group A: $31 Group B: $31 |
TRICARE Select (not including TRICARE Young Adult)
| Service | Active Duty Family Members | Retirees and Their Family Members |
|---|---|---|
| Primary Care Outpatient Office Visits | Group A: Network Provider: $22 Group B: Network Provider: $15 | Group A: Network Provider: $30 Group B: Network Provider: $26 |
Specialty Care Outpatient (this includes physical, occupational | Group A: Network Provider: $34 Group B: Network Provider: $26 | Group A: Network Provider: $46 Group B: Network Provider: $42 |
TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)
| Service | TRS | TRR |
|---|---|---|
| Primary Care Outpatient Office Visits | Network Provider: $15 Non-Network Provider: 20% | Network Provider: $26 Non-Network Provider: 25% |
Specialty Care Outpatient (this includes physical, occupational | Network Provider: $26 Non-Network Provider: 20% | Network Provider: $42 Non-Network Provider: 25% |
Tricare Prime Copay 2021
TRICARE Young Adult (TYA)
Tricare Select Copay 2020
| Service | TYA Prime | TYA Select | ||
|---|---|---|---|---|
| Active Duty Family Members | Retiree Family Members | Active Duty Family Members | Retiree Family Members | |
| Primary Care Outpatient Office Visits | $0 | $21 | Network Provider: $15 Non-Network Provider: 20% | Network Provider: $26 Non-Network Provider: 25% |
Specialty Care Outpatient Office Visits (this includes physical, | $0 | $31 | Network Provider: $26 Non-Network Provider: 20% | Network Provider: $42 Non-Network Provider: 25% |