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- Tricare Prime Copay 2020 Dates
- 2020 Retirees And Their Family Members Costs ... - TRICARE West
Costs
TRICARE Young Adult Prime $459 Not available TRICARE Young Adult Select $257 Not available When enrolled in a premium-based health plan (TRS, TRR, TYA Prime, TYA Select, or CHCBP), you pay a monthly or quarterly premium and follow Group B deductibles and applicable copayments or cost-shares. Quarterly Premium (Oct. Jan 27, 2021 Tricare Prime: Tricare Select: Annual Deductible: None: Group A: $50/individual or $100/family for E-4 & below; $150/$300 for E-5 & above.
Find your TRICARE costs, including copayments,enrollment fees, and payment options.
There are four TRICARE Prime options:
- TRICARE Prime
- TRICARE Prime Remote
- TRICARE Prime Overseas
- TRICARE Prime Remote Overseas
Active Duty Service Members
You must enroll in one of the Prime plans. You will have:
- No out-of-pocket costs
- No enrollment fees
- No network copayments
- No point-of-service fees
Active Duty Family Members*
If you enroll in one of the Prime plans, you will have:
- Minimal out-of-pocket costs
- No enrollment fees
- No network copayments
- Point-of-service fees if using the point-of-service option
*Includes family members of activatedCalled or ordered to active duty service for more than 30 days in a row. Guard/Reserve members
Retired Service Members, Their Families, and Other Beneficiaries
You can enroll in TRICARE Prime depending on where you live. You will pay:
- Annual enrollment fees
- Network copayments
- Point-of-service fees if using the point-of-service option
Last Updated 8/25/2020
Find a Doctor
Note: Visit our Copayment and Cost-Share Information page for 2021 costs.
View the cost information below for retirees and their family members (not including TRICARE Young Adult) with sponsors who enlisted before Jan. 1, 2018.
See Full List On Tricare-west.com
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| TRICARE Prime | TRICARE Select | |
|---|---|---|
| Enrollment Fees | $300/individual, $600/family (annually) | $0 |
| Annual Deductibles | $0 | $150/individual, $300/family |
| Catastrophic Cap | $3,000 per calendar year | $3,000 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 Provider: $90 Non-Network Provider: 25% |
| Ambulatory Surgery | $62 | Network Provider: 20% Non-Network Provider: 25% |
| Ancillary Services | $0 | Network Provider: $0 Non-Network Provider: 25% |
| Durable Medical Equipment | 20% | Network Provider: 20% Non-Network Provider: 25% |
| Emergency Room | $62 | Network Provider: $118 Non-Network Provider: 25% |
| Home Health Care | $0* | $0* |
| Hospice Care | $0 | $0 |
| Hospitalization - Physical Health | $156 per admission | Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: Lesser of $1,035 per day or 25%, plus 25% of professional fees |
| Hospitalization - Mental Health | $156 per admission | Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: 25% |
| Laboratory and X-Rays | $0 | Network Provider: $0 Non-Network Provider: 25% |
| Maternity Care - Inpatient Delivery Setting | $156 per admission | Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: Lesser of $1,035 per day or 25%, plus 25% of professional fees |
| Office Visits - Primary Care | $20 | Network Provider: $30 Non-Network Provider: 25% |
| Office Visits - Specialty Care | $31 | Network Provider: $45 Non-Network Provider: 25% |
| Outpatient Mental Health Visits | $31 | Network Provider: $45 Non-Network Provider: 25% |
| Partial Hospitalization | $31 per day** | Network Provider: $45** Non-Network Provider: 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 Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: 25% of allowable charges |
| Skilled Nursing Facility | $31 per day | Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: 25% of allowable charges |
| Urgent Care Services | $31 | Network Provider: $30 Non-Network Provider: 25% |
Tricare Prime Copay 2020 Dates
*Costs may apply for durable medical equipment (DME) and medications/drugs.
2020 Retirees And Their Family Members Costs ... - TRICARE West
**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.