Deductibles

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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:

E4 and Below: $56/individual, $112/family
E5 and Above: $168/individual, $336/family

Group A

$150/individual, $300/family

Group B: 

Network Providers: $168/individual, $336/family
Non-Network Providers: $336/individual, $672/family

TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)

TRICARE Reserve Select (TRS) TRICARE Retired Reserve (TRR)
E4 and Below: $56/individual, $112/family
E5 and Above: $168/individual, $336/family
 
Network Providers: $168/individual, $336/family
Non-Network Providers: $336/individual, $672/family
 

TRICARE Young Adult

The TRICARE Young Adult deductible is based on the sponsor's status.

TYA Prime TYA Select
Active Duty
Family Members
Retiree Family
Members
Active Duty Family Members Retiree Family Members
$0 $0

E4 and Below: $56
E5 and Above: $168

Network Providers: $168
Non-Network Providers: $336