2023 Cost Information for Ambulance (Ground) Services
- 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.
- 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.
Outpatient costs are applied to the following transports:
- beneficiary's residence, accident scene or other location to a civilian, military or VA hospital, or skilled nursing facility (SNF)
- hospital or SNF to the beneficiary's residence
Inpatient costs are applied to the following transports:
- between hospitals or SNFs
- emergency room or civilian hospital to a military or VA hospital
- emergency room to a hospital more capable of providing the required level of care
TRICARE Prime and TRICARE Prime Remote (not including TRICARE Young Adult)
| Active Duty Family Members |
Retirees and Their Family Members |
|---|
Group A:
Outpatient: $0
Inpatient: $0
Group B:
Outpatient: $0
Inpatient: $0
|
Group A:
Outpatient: $48
Inpatient: 25%
Group B:
Outpatient: $48
Inpatient: 25%
|
TRICARE Select (not including TRICARE Young Adult)
| Active Duty Family Members |
Retirees and Their Family Members |
|---|
Group A:
Outpatient:
Network Provider: $75
Non-Network Provider: 20%
Inpatient: 20%
Group B:
Outpatient:
Network Provider: $18
Non-Network Provider: 20%
Inpatient: 20%
|
Group A:
Outpatient:
Network Provider: $100
Non-Network Provider: 25%
Inpatient: 25%
Group B:
Outpatient:
Network Provider: $73
Non-Network Provider: 25%
Inpatient: 25%
|
TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)
| TRS |
TRR |
|---|
Outpatient:
Network Provider: $18
Non-Network Provider: 20%
Inpatient: 20%
|
Outpatient:
Network Provider: $73
Non-Network Provider: 25%
Inpatient: 25%
|
TRICARE Young Adult (TYA)
| TYA Prime |
TYA Select |
|---|
| Active Duty Family Members |
Retiree Family Members |
Active Duty Family Members |
Retiree Family Members |
Outpatient: $0
Inpatient: $0 |
Outpatient: $48
Inpatient: 25% |
Outpatient:
Network Provider: $18
Non-Network Provider: 20%
Inpatient: 20%
|
Outpatient:
Network Provider: $73
Non-Network Provider: 25%
Inpatient: 25%
|
