Deductible
Quick Definition
Amount you pay before TRICARE starts cost-sharing.
Video Explanation
Full Definition
The deductible is the amount you must pay out-of-pocket for covered services each fiscal year before TRICARE begins paying its share. Deductibles apply to TRICARE Select but not to TRICARE Prime.
TRICARE Select deductibles (2024): • Active Duty Family Members: $171 individual / $342 family • All others (Group A retirees): $195 individual / $390 family • All others (Group B retirees): $221 individual / $442 family
Key points about deductibles: • Reset annually on October 1 (start of fiscal year) • Apply per individual until family maximum reached • Only covered services count toward deductible • Military Treatment Facility care doesn't require deductibles • Network providers result in lower overall costs
Example If your individual deductible is $195 and you have a $500 surgery, you pay the first $195, then TRICARE cost-sharing begins for the remaining $305.
TRICARE Prime members don't pay deductibles—one of the key cost advantages of Prime over Select. All deductible payments count toward your annual catastrophic cap.
Related Questions
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 TRICARE options are available for Reserve and National Guard members?
Reserve and Guard members have TRICARE Reserve Select when not activated, and regular TRICARE when on active duty orders over 30 days.
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.
How do TRICARE deductibles work?
TRICARE Select has annual deductibles that must be met before cost sharing begins. Individual and family deductibles vary by beneficiary group.
What are the TRICARE costs for 2026?
TRICARE 2026 costs vary by plan and beneficiary group. Active duty members pay nothing, while retirees pay enrollment fees, copays, and deductibles that are adjusted annually.
Can I have TRICARE and employer insurance at the same time?
Yes, you can have both TRICARE and employer-sponsored health insurance. TRICARE coordinates benefits with other health insurance (OHI), which can reduce your out-of-pocket costs.
What is the TRICARE catastrophic cap for 2026?
The TRICARE catastrophic cap is the annual limit on out-of-pocket expenses. For 2026, active duty families pay no more than $1,000, while retiree family caps range from approximately $3,500 to $4,500.
What is TRICARE Select?
TRICARE Select is a self-managed preferred provider plan similar to a PPO that offers more flexibility in choosing providers without referrals, but with higher out-of-pocket costs.
What is the TRICARE catastrophic cap?
The catastrophic cap is the maximum amount a TRICARE beneficiary family will pay out of pocket for covered services in a fiscal year, after which TRICARE pays 100%.
What is an EOB in TRICARE?
An EOB (Explanation of Benefits) is a statement from TRICARE that details the services billed, amounts paid by TRICARE, and any remaining costs the beneficiary owes.
What is a point-of-service option in TRICARE?
The point-of-service option allows TRICARE Prime enrollees to see non-network providers without a referral, but with significantly higher out-of-pocket costs.
What is cost-sharing in TRICARE?
Cost-sharing in TRICARE refers to the portion of healthcare expenses that beneficiaries pay out of pocket, including enrollment fees, deductibles, copays, and cost-shares.
What is TRICARE Standard?
TRICARE Standard was the former fee-for-service health plan that allowed beneficiaries to see any TRICARE-authorized provider. It was replaced by TRICARE Select on January 1, 2018.
Related Terms
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