2024 Retirees and Their Family Members Costs (Group A)

Note: Visit our Copayment and Cost-Share Information page for 2023 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.

	TRICARE Prime	TRICARE Select
Annual Enrollment Fees	$363/individual, $726/family	$177.96/individual, $355.92/family Medically Retired or Survivor: $0
Annual Deductibles	$0	$150/individual, $300/family
Annual Catastrophic Cap	$3,000 per calendar year	Retirees: $4,157 per calendar year Medically Retired or Survivor: $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 (air)	$20	25%
Ambulance Services - Outpatient (ground)	$50	Network Provider: $106 Non-Network Provider: 25%
Ambulatory Surgery	$75	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	$75	Network Provider: $139 Non-Network Provider: 25%
Home Health Care	$0*	$0*
Hospice Care	$0	$0
Hospitalization - Physical Health	$188 per admission	Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: Lesser of $1,221 per day or 25%, plus 25% of professional fees
Hospitalization - Mental Health	$188 per admission	Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: Lesser of $1,221 per day or 25%, plus 25% of professional fees
Laboratory and X-Rays	$0	Network Provider: $0 Non-Network Provider: 25%
Maternity Care - Inpatient Delivery Setting	$188 per admission	Network Provider: Lesser of $250 per day or 25%, plus 20% of professional fees Non-Network Provider: Lesser of $1,221 per day or 25%, plus 25% of professional fees
Office Visits - Primary Care	$25	Network Provider: $36 Non-Network Provider: 25%
Office Visits - Specialty Care	$37	Network Provider: $50 Non-Network Provider: 25%
Outpatient Mental Health Visits	$37	Network Provider: $50 Non-Network Provider: 25%
Partial Hospitalization	$37 per day**	Network Provider: $50** Non-Network Provider: 25%
Preventive Services - Eye Examinations	$0	Not a covered benefit
Preventive Services - All Other Covered Services	$0	$0
Residential Treatment Center	$37 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	$37 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	$37	Network Provider: $36 Non-Network Provider: 25%

*Costs may apply for durable medical equipment 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.