TRICARE Fee Guide: 2026 Costs and Copays

*TRICARE.com is an independent reference site and is not the official TRICARE program or the Defense Health Agency. For official policy and the most current data, visit TRICARE.mil.*

## Quick answer TRICARE fees are the out-of-pocket costs you pay for healthcare, including annual enrollment fees, deductibles, and cost-shares (copayments). These amounts depend on your specific plan, your sponsor’s military status, and whether you fall into Group A or Group B based on when the sponsor joined the military.

## In detail Understanding TRICARE fees requires looking at four specific cost categories. As of 2026, many costs are subject to an annual cost-of-living adjustment.

### 1. Enrollment Fees and Premiums * **TRICARE Prime:** Active duty service members (ADSMs) and their families pay $0. Retirees and their families pay an annual enrollment fee. * **TRICARE Select:** Active duty families pay $0. Retirees (Group B) pay an annual enrollment fee. * **Premium-based plans:** TRICARE Reserve Select (TRS), TRICARE Retired Reserve (TRR), and TRICARE Young Adult (TYA) require monthly premiums regardless of status.

### 2. Annual Deductibles The deductible is the amount you pay out-of-pocket before TRICARE begins to share the cost of covered services. * **Prime:** No deductible for clinical care (unless using the Point of Service option). * **Select:** Deductibles vary by rank and beneficiary group. For 2026, an E-4 and below on Select may have a significantly lower deductible than an O-4 or a retiree.

### 3. Cost-Shares and Copayments Once the deductible is met, you pay either a fixed "copayment" or a percentage "cost-share." * **In-Network:** Generally fixed copayments (e.g., $38 for a primary care visit for a retiree in 2026). * **Out-of-Network:** Generally a percentage of the TRICARE-allowable amount (e.g., 25% of the bill).

### 4. The Catastrophic Cap This is your safety net. It is the maximum amount you will pay out-of-pocket in a calendar year for all TRICARE-covered services. Once you hit this limit, TRICARE pays 100% of the allowable amount for the rest of the year. For 2026, these caps range from roughly $1,288 for active duty families to over $4,000 for some retirees, depending on the plan.

## Who this applies to * **Active Duty Families:** Generally pay $0 for most care unless using TRICARE Select or non-network providers. * **Retirees and Families:** Subject to annual enrollment fees and higher copayments than active duty members. * **National Guard and Reserve:** Pay monthly premiums for TRS or TRR coverage. * **Group A vs. Group B:** "Group A" (Sponsor enlisted before Jan 1, 2018) generally has lower fees than "Group B" (Sponsor enlisted on or after Jan 1, 2018).

Common scenarios

**Scenario 1: Retiree Specialist Visit (2026)** An Army retiree in the West Region (managed by TriWest) sees a cardiologist. They have TRICARE Prime. There is no deductible. The retiree pays a fixed copayment of roughly $50 (2026 rates) for the specialist visit.

**Scenario 2: Active Duty Family Emergency (2026)** An E-5 spouse in the East Region (managed by Humana Military) goes to an in-network Emergency Room. Because they are on TRICARE Prime, their cost is $0. If they were on TRICARE Select, they might pay a small fixed copayment once their deductible is met.

**Scenario 3: TRICARE Reserve Select Pregnancy (2026)** A Reservist pays a monthly premium of approximately $55 (individual) to $260 (family) for TRS coverage. During a hospital stay for childbirth, they pay a percentage cost-share of the allowable amount until they reach their annual catastrophic cap.

## Related terms * **Allowable Charge:** The maximum amount TRICARE will pay for a specific medical service. * **Catastrophic Cap:** The most you pay out-of-pocket for covered services per calendar year. * **Cost-Share:** A percentage of the total cost you pay (common in TRICARE Select). * **Copayment:** A fixed dollar amount you pay for a service (common in TRICARE Prime). * **Premium:** A recurring monthly payment to maintain insurance coverage (TRS, TRR, TYA).

## Sources * **TRICARE.mil Costs:** https://www.tricare.mil/costs * **Humana Military (East Contractor):** https://www.humanamilitary.com/ * **TriWest Healthcare Alliance (West Contractor):** https://www.triwest.com/ * **Defense Health Agency (DHA):** https://health.mil/