Tricare Prime Retiree Copay
When leaving active duty, Service members may be entitled to or eligible for benefits offered by TRICARE and Department of Veterans Affairs (VA), depending on whether the Service member retires or separates. If retiring, the Service member is eligible for TRICARE as a military retiree and may also be eligible for certain VA benefits.
Coronavirus (COVID-19) Update:
Providers are expected to refund cost-sharing amounts to beneficiaries as appropriate. |
- 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).
- If you enroll in TRICARE Prime during TRICARE's Open Season, your enrollment is effective January 1 of the following year. Enrollment due to a qualifying life event (QLE), such as adding a newborn, is effective the date of the QLE. Retired service members and their family members have an annual enrollment fee for TRICARE Prime.
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. TRICARE Prime Out-of-Pocket Costs ADSMs, ADFMs, and transitional survivors Covered service Group A Group B All covered services $0 $0 Retirees, their families, and all others Covered service Group A Group B Preventive Care Visit $0 $0 Primary Care Outpatient Visit $21 $21 Specialty Care Outpatient Visit $31 $31 Urgent Care Center Visit $31 $31.
- 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: $21 Group B: $21 |
Specialty Care Outpatient Best photo editing programs for mac. (this includes physical, occupational | 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 Group B: Network Provider: $15 | Group A: Network Provider: $30 Group B: Network Provider: $26 |
Specialty Care Outpatient (this includes physical, occupational | Group A: Network Provider: $34 Group B: Network Provider: $26 | Group A: Network Provider: $46 Group B: Network Provider: $42 |
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 (this includes physical, occupational | Network Provider: $26 Non-Network Provider: 20% | Network Provider: $42 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 | $21 | Network Provider: $15 Non-Network Provider: 20% | Network Provider: $26 Non-Network Provider: 25% |
Specialty Care Outpatient Office Visits (this includes physical, | $0 | $31 | Network Provider: $26 Non-Network Provider: 20% | Network Provider: $42 Non-Network Provider: 25% |
Costs
Find your TRICARE costs, including copayments,enrollment fees, and payment options.
- Most costs are for calendar year 2021 unless noted separately.
- For US Family Health Plan and TRICARE Prime Remote costs, choose 'TRICARE Prime' from the pull-down menu
- Visit the Cost Terms page for definitions to help you better understand TRICARE costs.
- If you're an unremarried former spouse, for the Continued Health Care Benefit Program (CHCBP), chose 'Retired' regardless of your sponsor's status
- Looking for dental costs? Visit the TRICARE Dental Costs section.
Tricare Prime Cost 2021
Tricare Prime Retired Copays 2019
Tricare Prime Retiree Prescription Copay
Copayments will be waived retroactively to March 18 for certain testing and office visits related to the testing. The test must be one approved, cleared, or authorized by the Food and Drug Administration to detect SARS-CoV-2 or diagnose COVID-19. If you paid any copayments for testing related to COVID-19 and the resulting office visits with a network or non- network provider, you may file a claim for reimbursement. For more information related to the coronavirus, visit the FAQ page.