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:
2018: E4 and Below: $50/individual, $100/family
E5 and Above: $150/individual, $300/family
2019: E4 and Below: $51/individual, $102/family
E5 and Above: $154/individual, $308/family
|
Group A:
$150/individual, $300/family
Group B:
2018: Network Providers: $150/individual, $300/family
Non-network Providers: $300/individual, $600/family
2019: Network Providers: $154/individual, $308/family
Non-network Providers: $308/individual, $616/family
|
TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)
| TRICARE Reserve Select (TRS) |
TRICARE Retired Reserve (TRR) |
|---|
2018: E4 and Below: $50/individual, $100/family
E5 and Above: $150/individual, $300/family
2019: E4 and Below: $51/individual, $102/family
E5 and Above: $154/individual, $308/family
|
2018: Network Providers: $150/individual, $300/family
Non-network Providers: $300/individual, $600/family
2019: Network Providers: $154/individual, $308/family
Non-network Providers: $308/individual, $616/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 |
2018:
E4 and Below: $50/individual
E5 and Above: $150/individual
2019:
E4 and Below: $51/individual
E5 and Above: $154/individual
|
2018:
Network Providers: $150/individual
Non-network Providers: $300/individual
2019:
Network Providers: $154/individual
Non-network Providers: $308/individual
|
