Annual deductibles apply to network and non-network providers for outpatient services only.

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• 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)

Tricare Prime Retired Er Copay

TRICARE Select (not including TRICARE Young Adult)

TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)

TRICARE Young Adult

The TRICARE Young Adult deductible is based on the sponsor's status.

• Copayments and cost-shares are subject to change at the beginning of each calendar year.
  • Copayments are per occurrence or per visit.
  • Cost-shares are a percentage of the contracted rate for network providers and the maximum TRICARE allowable for non-network providers on certain types of services.
• Beneficiaries have an out-of-pocket maximum for covered medical expenses; this is known as the catastrophic cap.
• Point of Service cost-shares and deductibles may apply to TRICARE Prime and TRICARE Prime Remote beneficiaries (excluding active duty service members).

Important Note: Active duty service members do not have any out-of-pocket costs for care.

2021 Costs

2021 Cost Information by Benefit

Detailed information on copayments and cost-shares is listed below by benefit. You can also view this information using the cost links in our Benefits A-Z list.

Tricare Prime Ambulance Copays

Is There A Copay For Tricare Prime