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2020 Retirees and Their Family Members Costs (Group B)

Note: Visit our Copayment and Cost-Share Information page for 2019 costs.

View the cost information below for retirees and their family members (not including TRICARE Young Adult) with sponsors who enlisted on or after Jan. 1, 2018

  TRICARE Prime TRICARE Select
Enrollment Fees $366/individual, $732/family
(annually)
$471/individual, $942/family
(annually)
Annual Deductibles $0 Network Providers: $156/individual, $313/family
Non-Network Providers: $313/individual, $626/family
Catastrophic Cap $3,655 per calendar year $3,655 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: $62
Non-Network: 25%
Ambulatory Surgery $62 Network: $99
Non-Network: 25%
Ancillary Services $0 Network: $0
Non-Network: 25%
Durable Medical Equipment 20% Network: 20%
Non-Network: 25%
Emergency Room $62 Network: $83
Non-Network: 25%
Home Health Care $0* $0*
Hospice Care $0 $0
Hospitalization (Includes Mental Health) $156 per admission Network Provider: $182 per admission
Non-Network Provider: 25% of allowable charges
Laboratory and X-Rays $0 Network Provider: $0
Non-Network Provider: 25%
Maternity Care
(Office Visits and Delivery Planned in an Inpatient Setting)
$156 per admission Network: $182 per admission
Non-Network: 25% of allowable charges
Office Visits (Primary Care) $20 Network: $26
Non-Network: 25%
Office Visits (Specialty Care) $31 Network: $41
Non-Network: 25%
Outpatient Mental Health Visits $31 Network: $41
Non-Network: 25%
Partial Hospitalization $31 per day** Network: $41**
Non-Network: 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: $52 per day
Non-Network: Lesser of $313
per day or 20% of allowable charges
Skiilled Nursing Facilty $31 per day Network: $52 per day
Non-Network: Less of $313
per day or 20% of allowable charges
Urgent Care Services $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.