TRICARE Deductible Information
Annual deductibles apply to network and non-network providers for outpatient services only.
- 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.
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)
| Active Duty Family Members |
Retirees and Their Family Members |
|---|
Group A: $0
Group B: $0
Point of Service deductibles are calculated separately.
|
Group A: $0
Group B: $0
Point of Service deductibles are calculated separately.
|
TRICARE Select (not including TRICARE Young Adult)
| Active Duty Family Members |
Retirees and Their Family Members |
|---|
Group A:
E4 and Below: $50/individual, $100/family
E5 and Above: $150/individual, $300/family
Group B:
2020: E4 and Below: $52/individual, $104/family
E5 and Above: $156/individual, $313/family
2021: E4 and Below: $52/individual, $105/family
E5 and Above: $158/individual, $317/family
|
Group A:
$150/individual, $300/family
Group B:
2020: Network Providers: $156/individual, $313/family
Non-Network Providers: $313/individual, $626/family
2021: Network Providers: $158/individual, $317/family
Non-Network Providers: $317/individual, $634/family
|
TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)
| TRICARE Reserve Select (TRS) |
TRICARE Retired Reserve (TRR) |
|---|
2020: E4 and Below: $52/individual, $104/family
E5 and Above: $156/individual, $313/family
2021: E4 and Below: $52/individual, $105/family
E5 and Above: $158/individual, $317/family
|
2020: Network Providers: $156/individual, $313/family
Non-Network Providers: $313/individual, $626/family
2021: Network Providers: $158/individual, $317/family
Non-Network Providers: $317/individual, $634/family
|
TRICARE Young Adult
The TRICARE Young Adult deductible is based on the sponsor's status.
| TRICARE Prime |
TRICARE Select |
|---|
Active Duty
Family Members |
Retiree Family
Members |
Active Duty Family Members |
Retiree Family Members |
| $0 |
$0 |
2020:
E4 and Below: $52/individual
E5 and Above: $156/individual
2021:
E4 and Below: $52/individual
E5 and Above: $158/individual
|
2020:
Network Providers: $156/individual
Non-Network Providers: $313/individual
2021:
Network Providers: $158/individual
Non-Network Providers: $317/individual
|
