How do TRICARE deductibles work?
Quick Answer
TRICARE Select has annual deductibles that must be met before cost sharing begins. Individual and family deductibles vary by beneficiary group.
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Key Takeaways
- Select has deductibles; Prime does not
- Deductibles reset each January
- Individual costs count toward family
- Different amounts by group
Detailed Answer
Deductibles are the amount you pay for covered services before TRICARE starts cost sharing.
TRICARE Prime
- No deductibles for most services
- Only copays apply
- Active duty: No cost sharing
TRICARE Select Deductibles (2024)
- Active Duty Family: $50 individual / $100 family
- Group A Retiree: $150 individual / $300 family
- Group B Retiree: $50 individual / $100 family
How Deductibles Work
- Calendar year (Jan 1 - Dec 31)
- Individual counts toward family
- Once met, cost shares apply
- Resets each January
What Counts Toward Deductible
- Most covered outpatient services
- Some pharmacy costs
- Lab and diagnostic tests
- Network and non-network costs
What Doesn't Count
- Copays for Prime
- Some preventive services
- Services not covered by TRICARE
Related TRICARE Terms
Related Questions
How does the TRICARE catastrophic cap work?
The catastrophic cap is your maximum annual out-of-pocket cost. Once reached, TRICARE pays 100% of covered services for the rest of the fiscal year.
What are the cost shares for TRICARE Select?
TRICARE Select has annual deductibles, percentage-based cost shares for most services, and a catastrophic cap that limits yearly out-of-pocket costs.
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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