2023 Active Duty Family Members Costs (Group A)
Note: Visit our Copayment and Cost-Share Information page for 2024 costs.
View the cost information below for active duty family members (not including TRICARE Young Adult) with sponsors who enlisted before Jan. 1, 2018.
Active duty service members must be enrolled in a TRICARE Prime plan and do not have any enrollment fees, out-of-pocket costs, network copayments, or the point-of-service option.
| |
TRICARE Prime |
TRICARE Select |
|---|
| Enrollment Fees |
$0 |
$0 |
| Annual Deductibles |
$0 |
E-4 and below: $50/individual, $100/family
E-5 and above: $150/individual, $300/family |
| Catastrophic Cap |
$1,000 per calendar year |
$1,000 per calendar year |
Note: Point of Service cost-shares and deductibles may apply to TRICARE Prime and TRICARE Prime Remote beneficiaries (excluding active duty service members).
Annual deductibles apply to outpatient services only.
| Type of Care |
TRICARE Prime
|
TRICARE Select |
|---|
| Ambulance - Outpatient |
$0 |
Network Provider: $75
Non-Network Provider: 20% |
| Ambulatory Surgery |
$0 |
Network Provider: $25
Non-Network Provider: $25 |
| Ancillary Services |
$0 |
Network Provider: $0
Non-Network Provider: 20% |
| Durable Medical Equipment |
$0 |
Network Provider: 15%
Non-Network Provider: 20% |
| Emergency Room |
$0 |
Network Provider: $103
Non-Network Provider: 20% |
| Home Health Care |
$0 |
$0* |
| Hospice Care |
$0 |
$0 |
| Hospitalization (includes mental health) |
$0 |
$21.30 per day
($25 min charge) |
| Laboratory and X-Rays |
$0 |
Network Provider: $0
Non-Network Provider: 20% |
Maternity Care - Inpatient Delivery Setting
|
$0 |
$21.30 per day
($25 min charge) |
| Office Visits - Primary Care |
$0 |
Network Provider: $25
Non-Network Provider: 20% |
| Office Visits - Speciality Care |
$0 |
Network Provider: $37
Non-Network Provider: 20% |
| Outpatient Mental Health Visits |
$0 |
Network Provider: $37
Non-Network Provider: 20% |
| Partial Hospitalization |
$0 |
Network Provider: $37*
Non-Network Provider: 20% |
| Preventive Services - Eye Examinations |
$0 |
Network Provider: $0
Non-Network Provider: 20% |
| Preventive Services - Female tubal Ligation (effective Jan. 1, 2023) |
$0 |
Network Provider: $0
Non-Network Provider: 20% |
| Preventive Services - Alll Other Covered Services |
$0 |
$0 |
| Residential Treatment Center |
$0 |
$21.30 per day
($25 min charge) |
| Skilled Nursing Facility |
$0 |
$21.30 per day
($25 min charge) |
| Urgent Care Services |
$0 |
Network Provider: $25
Non-Network Provider: 20% |
*Costs may apply for durable medical equipment (DME) and medications/drugs.
**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.
