Copayment

Fixed amount you pay for covered services.

A copayment (or copay) is a fixed dollar amount you pay for covered healthcare services at the time of service. The amount varies based on your TRICARE plan, the type of service, and your beneficiary category.

Common copayment examples: • TRICARE Prime civilian provider visit: $0-$34 (varies by rank/status) • TRICARE Select civilian provider visit: Greater of $31 or 27% of negotiated fee • Emergency room visit: $104 (TRICARE Prime), varies (TRICARE Select) • Urgent care: $34 (TRICARE Prime), varies (TRICARE Select)

Copays vs. Cost-shares: • Copays: Fixed dollar amounts (e.g., $31 per visit) • Cost-shares: Percentage of allowable charge (e.g., 20% of the bill)

Active duty service members never pay copays for any care. Active duty family members have lower copays than retirees and their families.

All copays count toward your annual catastrophic cap, providing financial protection against high healthcare costs. Military Treatment Facilities typically don't charge copays for most services.