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TRICARE Plan Costs: 2026 Fees, Deductibles, & Copays

Comprehensive guide to TRICARE 2026 plan costs, including enrollment fees, deductibles, and copays for Prime and Select beneficiaries.

TRICARE Plan Costs: 2026 Fees, Deductibles, & Copays

*Disclaimer: TRICARE.com is an independent reference site and is not the official TRICARE program or a government agency. For official policy and the most current enrollment data, visit TRICARE.mil.*

## Quick answer TRICARE costs depend on your military status (Active Duty vs. Retired), the plan you choose (Prime vs. Select), and your "Sponsor's" initial enlistment date. While Active Duty families usually pay $0 for care, retirees and families of those who joined after 2018 often face annual enrollment fees, deductibles, and flat-rate copays for medical visits.

In detail

TRICARE costs are categorized by **Groups**. Your group determines your fee structure for the life of your coverage: * **Group A:** Sponsor’s enlistment or appointment was **before** Jan. 1, 2018. * **Group B:** Sponsor’s enlistment or appointment was **on or after** Jan. 1, 2018.

### 1. Enrollment Fees Active Duty Service Members (ADSMs) and their families pay **$0** in enrollment fees. For retirees, fees apply: * **TRICARE Prime (Retirees):** For 2026, Group A retirees pay approximately $391.92/individual or $783.84/family per year. Group B rates are typically higher—check TRICARE.mil for the exactly indexed 2026 figures. * **TRICARE Select (Retirees):** Group A retirees must pay an annual enrollment fee (roughly $189/individual or $378/family in 2026).

### 2. Deductibles (Annual) This is what you pay out-of-pocket before TRICARE begins to share costs. * **TRICARE Prime:** $0 for all users (unless using the Point-of-Service option). * **TRICARE Select (Active Duty Families):** Group A pays $50/individual or $100/family. Group B pays $60/individual or $121/family (2026 rates). * **TRICARE Select (Retirees):** Group A pays $150/individual or $300/family. Group B pays significantly higher, indexed annually.

### 3. Out-of-Pocket Costs (2026 Estimates) | Service Type | Prime (Active Duty) | Prime (Retirees) | Select (ADFM Group A) | Select (Retiree Group A) | | :--- | :--- | :--- | :--- | :--- | | **Primary Care** | $0 | ~$27 | $21 | ~$37 | | **Specialty Care** | $0 | ~$39 | $33 | ~$50 | | **Emergency Room** | $0 | ~$79 | $103 | ~$146 | | **Urgent Care** | $0 | ~$39 | $25 | ~$37 |

### 4. Catastrophic Cap The Catastrophic Cap is the most you will pay for covered TRICARE services in a calendar year. * **Active Duty Families:** Approximately $1,000–$1,217 per year (varies by Group). * **Retirees:** Approximately $4,000–$4,520 (varies by Group and Plan). Once this cap is hit, TRICARE pays 100% of covered services for the rest of the year.

## Who this applies to * **Active Duty Families:** Focus on Group A vs. B for Select deductibles; Prime remains $0 out-of-pocket for most. * **Retirees:** Must account for annual enrollment fees and higher copays than active-duty counterparts. * **National Guard/Reserve:** Subject to monthly premiums for TRICARE Reserve Select (TRS), regardless of Group. * **Young Adults:** Children age 21–26 pay high monthly premiums for TRICARE Young Adult (TYA).

Common scenarios

**Scenario 1: The Active Duty Family (Prime)** An Army E-5 and his wife are in Group A. They use TRICARE Prime at the local MTF (Military Treatment Facility). They pay **$0** for all doctor visits, prescriptions, and a planned surgery. Their total annual cost is **$0**.

**Scenario 2: The Retired Individual (Select)** A retired Navy Commander in Group A prefers to see a civilian doctor using TRICARE Select. In 2026, he pays a **$189 enrollment fee**. He pays a **$150 deductible**. For a primary care visit, he pays a **$37 copay**.

**Scenario 3: The Reserve Member (TRS)** A National Guard member uses TRICARE Reserve Select. She pays a **monthly premium** (approx. $53 for individual coverage in 2026), plus a deductible and small copays for each visit until her catastrophic cap is reached.

## Related terms * **Catastrophic Cap:** The maximum out-of-pocket limit you pay for covered services annually. * **Group A:** Beneficiaries whose sponsor entered service before January 1, 2018. * **Group B:** Beneficiaries whose sponsor entered service on or after January 1, 2018. * **Point-of-Service (POS):** An option allowing Prime users to see any doctor, but with a high $300+ deductible and 50% cost shares. * **Cost-Share:** The percentage of the total cost of a service you pay (usually applies to TRICARE Select).

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