Note: Visit our Copayment and Cost-Share Information page for 2021 costs.
2020 TRICARE Reserve Select Costs Note: Visit our Copayment and Cost-Share Information page for 2021 costs. View the cost information below for TRICARE Reserve Select (TRS) beneficiaries. 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. Nov 18, 2019 TRICARE Copayment Changes for 2020 October 09, 2019 The National Defense Authorization Act (NDAA) for fiscal year (FY) 2018 established changes to TRICARE prescription copayments every two years for the calendar years 2018 through 2027. These changes are for retail and home delivery only. Nov 20, 2020 The only other changes in cost for Tricare Prime in 2021 are $1 increases in primary care or emergency room visits, and those changes will affect only retirees in both Groups A and B.
View the cost information below for TRICARE Young Adult (TYA) beneficiaries.
Copay For Tricare Prime 2020
- The amounts are based on the TYA enrollee's sponsor's active duty or retiree status.
- The sponsor's enlistment date does not determine costs. Costs are based on those for Group B.
| Active Duty Family Member | Retiree Family Member | |||
|---|---|---|---|---|
| TYA Prime | TYA Select | TYA Prime | TYA Select | |
| Enrollment Fees | $376 per member (monthly) | $228 per member (monthly) | $376 per member (monthly) | $228 per member (monthly) |
| Annual Deductibles | $0 | E-4 and below: $52/individual E-5 and above: $156/individual | $0 | Network Providers: $156/individual Non-Network Providers: $313/individual |
| Catastrophic Cap | $1,044 per calendar year | $1,044 per calendar year | $3,655 per calendar year | $3,655 per calendar year |
Tricare Prime Copay 2020 Online
TRICARE Young Adult reminders:
- Point of Service cost-shares and deductibles may apply to TYA Prime beneficiaries.
- TRICARE Young Adult Select annual deductibles apply to outpatient services only.
| Type of Care | Active Duty Family Member | Retiree Family Member | ||
|---|---|---|---|---|
| TYA Prime | TYA Select | TYA Prime | TYA Select | |
| Ambulance Services (Outpatient) | $0 | Network: $15 Non-Network: 20% | $41 | Network: $62 Non-Network: 25% |
| Ambulatory Surgery | $0 | Network: $26 Non-Network: 20% | $62 | Network: $99 Non-Network: 25% |
| Ancillary Services | $0 | Network: $0 Non-Network: 20% | $0 | Network: $0 Non-Network: 25% |
| Durable Medical Equipment | $0 | Network: 10% Non-Network: 20% | 20% | Network: 20% Non-Network: 25% |
| Emergency Room | $0 | Network: $41 Non-Network: 20% | $62 | Network: $83 Non-Network: 25% |
| Home Health Care | $0 | $0* | $0* | $0* |
| Hospice Care | $0 | $0 | $0 | $0 |
| Hospitalization (Includes Mental Health) | $0 | Network: $62 per admission Non-Network: 20% | $156 per admission | Network: $182 per admission Non-Network: 25% |
| Laboratory and X-Rays | $0 | Network: $0 Non-Network: 20% | $0 | Network: $0 Non-Network: 25% |
| Maternity Care (Delivery Planned in an Inpatient Setting) | $0 | Network: $62 Non-Network: 20% | $156 per admission | Network: $182 Non-Network: 25% |
| Office Visits (Primary Care) | $0 | Network: $15 Non-Network: 20% | $20 | Network: $26 Non-Network: 25% |
| Office Visits (Specialty Care) | $0 | Network: $26 Non-Network: 20% | $31 | Network: $41 Non-Network: 25% |
| Outpatient Mental Health Visits | $0 | Network: $26 Non-Network: 20% | $31 | Network: $41 Non-Network: 25% |
| Partial Hospitalization | $0 | Network: $26** Non-Network: 20% | $31 per day** | Network: $41** Non-Network: 25% |
| Preventive Services (Eye Examinations) | $0 | Network: $0 Non-Network: 20% | $0 | Not a covered benefit |
| Preventive Services (All Other Covered Services) | $0 | $0 | $0 | $0 |
| Residential Treatment Center | $0 | Network: $26 per day Non-Network: $52 per day | $31 per day | Network: $52 per day Non-Network: Lesser of $313 per day or 20% of allowable charges |
| Skilled Nursing Facilty | $0 | Network: $26 per day Non-Network: $52 per day | $31 per day | Network: $52 per day Non-Network: Lesser of $313 per day or 20% of allowable charges |
| Urgent Care Services | $0 | Network: $20 Non-Network: 20% | $31 | Network: $41 Non-Network: 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.
Note: Visit our Copayment and Cost-Share Information page for 2021 costs.
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% |
Tricare Prime Copay 2020 Form
*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.