What are the TRICARE Prime copays for common services?
Quick Answer
TRICARE Prime copays range from $0 for preventive care to $30 for specialty visits. Active duty members have no copays; families have low copays.
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Key Takeaways
- Active duty: $0 for all care
- Families: Low copays ($0-$40)
- Preventive care usually $0
- ER copays are higher
Detailed Answer
TRICARE Prime uses flat-rate copays rather than percentage cost shares.
Active Duty Service Members
- All healthcare: $0
- No copays for any covered service
- Dental: Covered at MTF
Active Duty Family Members
- Primary care: $0-$15
- Specialty care: $20-$30
- Urgent care: $20
- Emergency room: $40
- Inpatient: $0 per day
Retirees and Families
- Primary care: $20-$25
- Specialty care: $30-$35
- Urgent care: $30
- Emergency room: $50
- Inpatient: $0 per day (after enrollment fees)
Preventive Care
- Most preventive: $0
- Annual physicals: $0
- Immunizations: $0
- Cancer screenings: $0
Mental Health
- Individual therapy: $20-$30
- Group therapy: $15-$20
- Inpatient: Per-day charge
Related TRICARE Terms
Related Questions
What is the difference between TRICARE Prime and TRICARE Select?
TRICARE Prime is a managed care option with a primary care manager and lower costs. TRICARE Select offers more flexibility to choose providers with higher out-of-pocket expenses.
How much does TRICARE cost?
Costs vary by plan and beneficiary status. Active duty members have no costs. Retirees and their families pay enrollment fees and cost-shares.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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