Cost-Share

Percentage of costs you pay for covered services.

Cost-share is the percentage of the TRICARE-allowable charge that you're responsible for paying when you receive healthcare services. Unlike fixed copayments, cost-shares are calculated as a percentage and vary based on the total cost of care.

TRICARE Select cost-share rates: • Active Duty Family Members: 15% (network), 20% (non-network) • Retirees and families: 20% (network), 25% (non-network)

Example calculation If a specialist visit has an allowable charge of $200: • Network provider, ADFM: You pay $30 (15% of $200) • Non-network provider, retiree: You pay $50 (25% of $200)

Important notes: • TRICARE Prime uses primarily copays, not cost-shares • TRICARE Select uses cost-shares for most services • All cost-shares count toward your catastrophic cap • Network providers result in lower cost-shares

The cost-share model means higher-cost services result in higher out-of-pocket expenses, making it important to understand your potential costs before receiving care.