Note: When enrolled in TRICARE Reserve Select (TRS), TRICARE Retired Reserve (TRR), TRICARE Young Adult (TYA), or the Continued Health Care Benefit Program (CHCBP), Group A beneficiaries follow Group B deductibles and applicable copayments or cost-shares. Drivers linx. TRICARE PRIME® (JAN. 31, 2021) Includes TRICARE Prime, TRICARE Prime Remote, the US. TRICARE is waiving copayments for doctor-ordered, approved COVID-19 testing, including associated office visits furnished on or after March 18, 2020. If you were tested and paid a copayment, you can file a claim for reimbursement.
The catastrophic cap is the maximum out-of-pocket amount the beneficiary will pay each calendar year for TRICARE-covered services. The beneficiary is not responsible for any amounts over the catastrophic cap in a given year, except for:
Tricare East Copayments
- Services that are not covered.
- Point of Service charges.
- The additional 15 percent non-participating providers may charge above the TRICARE allowable charge.
If the beneficiary changes programs during the calendar year under the same sponsor, any amount credited toward the catastrophic cap will roll over to the new program (does not apply to Continued Health Care Benefit Program [CHCBP]).
Download jdl input devices driver. A beneficiary's catastrophic cap is determined by the sponsor's initial enlistment or appointment date:
- Group A: Sponsor's enlistement or appointment date is before Jan. 1, 2018.
- Group B: Sponsor's enlistement or appointment date is on or after Jan. 1, 2018.
| Out-of-pocket expenses that apply towards cap | Out-of-pocket expenses that do NOT apply towards cap |
|---|---|
|
|
2021 Catastrophic Cap Amounts
| 2021 | Group A | Group B |
|---|---|---|
| Active Duty Family Members (TRICARE Prime and Select) | $1,000 per family, per calendar year | $1,058 per family, per calendar year |
| Retirees and Their Family Members (TRICARE Prime) | $3,000 per family, per calendar year | $3,703 per family, per calendar year |
| Retirees and Their Family Members (TRICARE Select) | $3,500 per family, per calendar year | $3,703 per family, per calendar year |
| TRICARE Reserve Select (TRS) | $1,058 per family, per calendar year | |
| TRICARE Retired Reserve (TRR) | $3,703 per family, per calendar year | |
| TRICARE Young Adult (TYA) | Active Duty Family Members:$1,058 per individual, per calendar year Retiree Family Members: $3,703 per individual, per calendar year | |
2020 Catastrophic Cap Amounts
| 2020 | Group A | Group B |
|---|---|---|
| Active Duty Family Members (TRICARE Prime and Select) | $1,000 per family, per calendar year | $1,044 per family, per calendar year |
| Retirees and Their Family Members (TRICARE Prime and Select) | $3,000 per family, per calendar year | $3,655 per family, per calendar year |
| TRICARE Reserve Select (TRS) | $1,044 per family, per calendar year | |
| TRICARE Retired Reserve (TRR) | $3,655 per family, per calendar year | |
| TRICARE Young Adult (TYA) | Active Duty Family Members:$1,044 per individual, per calendar year Retiree Family Members: $3,655 per individual, per calendar year | |
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 East Copay
Tricare North Copays
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.