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2020 Cost Information for Office Visits

Coronavirus (COVID-19) Update:

  • Testing copayment waiver: Retroactive to March 18, 2020, TRICARE will waive copayments/cost-shares for medically necessary COVID-19 diagnostic and antibody testing and related services, and office visits, urgent care or emergency room visits during which tests are ordered or administered. COVID-19 diagnostic and antibody tests must meet Families First Coronavirus Response Act (FFCRA) criteria in order to be eligible for the cost-share and copayment waivers.
  • 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. Beneficiaries who seek telehealth from non-network providers are liable for their regular copayment or cost-share. TRICARE Prime beneficiaries who seek care from specialists without an approved referral when required are subject to Point of Service fees.  

Providers are expected to refund cost-sharing amounts to beneficiaries as appropriate. 

Note: Visit our Copayment and Cost-Share Information page to view 2019 costs. 
 
  • 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 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: $20

Group B: $20

Specialty Care Outpatient
Office Visits

(this includes physical therapy, occupational
therapy and speech therapy)

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
Non-Network Provider: 20%

Group B: 

Network Provider: $15
Non-Network Provider: 20%

Group A: 

Network Provider: $30
Non-Network Provider: 25%

Group B: 

Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient
Office Visits

(this includes physical therapy, occupational
therapy and speech therapy)

Group A: 

Network Provider: $33
Non-Network Provider: 20%

Group B: 

Network Provider: $26
Non-Network Provider: 20%

Group A: 

Network Provider: $45
Non-Network Provider: 25%

Group B: 

Network Provider: $41
Non-Network Provider: 25%

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
Office Visits

(this includes physical therapy, occupational
therapy and speech therapy)

Network Provider: $26
Non-Network Provider: 20%
Network Provider: $41
Non-Network Provider: 25%

TRICARE Young Adult (TYA)

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 $20 Network Provider: $15
Non-Network Provider: 20%
Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient Office Visits

(this includes physical therapy, occupational
therapy and speech therapy)

$0 $31 Network Provider: $26
Non-Network Provider: 20%
Network Provider: $41
Non-Network Provider: 25%

 

Retiree Family Members