Tricare East Copay

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East

East

Coronavirus (COVID-19) Update:

  • Testing copayment waiver: Retroactive to March 18, 2020, TRICARE will waive copayments/cost-shares for medically necessary COVID-19 diagnostic and antibody testing and related services, and office visits, urgent care or emergency room visits during which tests are ordered or administered. COVID-19 diagnostic and antibody tests must meet Families First Coronavirus Response Act (FFCRA) criteria in order to be eligible for the cost-share and copayment waivers.
  • Telemedicine copayment waiver: TRICARE is waiving copayments and cost-shares for covered audio-only or audio/video telemedicine rendered by network providers on or after May 12, 2020. This waiver applies to covered in-network telehealth services, not just services related to COVID-19. Beneficiaries who seek telehealth from non-network providers are liable for their regular copayment or cost-share. TRICARE Prime beneficiaries who seek care from specialists without an approved referral when required are subject to Point of Service fees.

Providers are expected to refund cost-sharing amounts to beneficiaries as appropriate.

TRICARE is waiving copayments for doctor-ordered, approved COVID-19 testing, including associated office visits furnished on or after March 18, 2020. If you were tested and paid a copayment, you can file a claim for reimbursement. Update your TRICARE eligibility status. To update eligibility status for a family member, contact the Defense Enrollment Eligibility Reporting System (DEERS) at (800) 538-9552 and verify what documentation is required for the change. It is the responsibility of the TRICARE beneficiary, parent or legal representative to report a change in status. The TRICARE Pharmacy Program, administered by Express Scripts, is designed to provide the medications beneficiaries need, when they need them, in a safe, convenient and cost-effective manner. Note: Visit our Copayment and Cost-Share Information page to view 2020 costs. Ambulatory surgery costs apply to same day surgery in an outpatient hospital setting or ambulatory surgery center. TRICARE Select, TRICARE Young Adult Select, TRICARE Reserve Select, and TRICARE Retired Reserve annual deductibles apply.; TRICARE Young Adult costs are based on the sponsor's status. Note: When enrolled in TRICARE Reserve Select (TRS), TRICARE Retired Reserve (TRR), TRICARE Young Adult (TYA), or the Continued Health Care Benefit Program (CHCBP), Group A beneficiaries follow Group B deductibles and applicable copayments or cost-shares. TRICARE PRIME® (JAN. 31, 2021) Includes TRICARE Prime, TRICARE Prime Remote, the US.

Note: Visit our Copayment and Cost-Share Information page to view 2020 costs.
  • TRICARE Select, TRICARE Young Adult Select, TRICARE Reserve Select, and TRICARE Retired Reserve annual deductibles apply.
  • TRICARE Young Adult costs are based on the sponsor's status.
  • TRICARE Prime and TRICARE Young Adult Prime retirees have a separate copayment for allergy shots performed on a different day than the office visit, or performed by a different provider, such as an independent laboratory or radiology facility (even if performed on the same day as the related office visit).
  • Transitional Assistance Management Program (TAMP) beneficiaries (service members and their family members) follow the active duty family member copayment/cost-share information, based on the TRICARE plan type.

Tricare Prime Co Pay Chart

A beneficiary's cost is determined by the sponsor's initial enlistment or appointment date:

  • Group A: Sponsor's enlistment or appointment date occurred prior to Jan. 1, 2018.
  • Group B: Sponsor's enlistment or appointment date occurred on or after Jan. 1, 2018.

TRICARE Prime and TRICARE Prime Remote (not including TRICARE Young Adult)

ServiceActive Duty Family MembersRetirees and Their Family Members
Primary Care Outpatient
Office Visits

Group A: $0

Group B: $0

Group A: $21

Group B: $21

Specialty Care Outpatient
Office Visits

(this includes physical, occupational
and speech therapy, and provisional coverage benefits)

Group A: $0

Group B: $0

Group A: $31

Group B: $31

Tricare east copay 2021

TRICARE Select (not including TRICARE Young Adult)

ServiceActive Duty Family MembersRetirees and Their Family Members
Primary Care Outpatient
Office Visits

Group A:

Network Provider: $22
Non-Network Provider: 20%

Group B:

Network Provider: $15
Non-Network Provider: 20%

Group A:

Network Provider: $30
Non-Network Provider: 25%

Group B:

Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient
Office Visits

(this includes physical, occupational
and speech therapy, and provisional coverage benefits)

Group A:

Network Provider: $34
Non-Network Provider: 20%

Group B:

Network Provider: $26
Non-Network Provider: 20%

Group A:

Network Provider: $46
Non-Network Provider: 25%

Group B:

Network Provider: $42
Non-Network Provider: 25%

TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)

ServiceTRSTRR
Primary Care Outpatient
Office Visits		Network Provider: $15
Non-Network Provider: 20%		Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient
Office Visits

(this includes physical, occupational
and speech therapy, and provisional
coverage benefits)

Network Provider: $26
Non-Network Provider: 20%		Network Provider: $42
Non-Network Provider: 25%

Tricare East Copayments

Tricare

TRICARE Young Adult (TYA)

ServiceTYA PrimeTYA Select
Active Duty Family MembersRetiree Family MembersActive Duty Family MembersRetiree Family Members
Primary Care Outpatient Office Visits$0$21Network Provider: $15
Non-Network Provider: 20%		Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient Office Visits

(this includes physical,
occupational and speech therapy, and provisional coverage benefits)

$0$31Network Provider: $26
Non-Network Provider: 20%		Network Provider: $42
Non-Network Provider: 25%

Note: Visit our Copayment and Cost-Share Information page to view 2020 costs.

Ambulatory surgery costs apply to same day surgeryin an outpatient hospital setting or ambulatory surgery center.

  • TRICARE Select, TRICARE Young Adult Select, TRICARE Reserve Select, and TRICARE Retired Reserve annual deductibles apply.
  • TRICARE Young Adult costs are based on the sponsor's status.
  • Transitional Assistance Management Program (TAMP) beneficiaries (service members and their family members) follow the active duty family member copayment/cost-share information, based on the TRICARE plan type.
  • The copayments below are for facility fees. There is no separate copayment for professional fees.

A beneficiary's cost is determined by the sponsor's initial enlistment or appointment date:

South

Tricare Humana Copay

  • Group A: Sponsor's enlistment or appointment date occurred prior to Jan. 1, 2018.
  • Group B: Sponsor's enlistment or appointment date occurred on or after Jan. 1, 2018.

TRICARE Prime and TRICARE Prime Remote (not including TRICARE Young Adult

Active Duty Family MembersRetirees and Their Family Members

Group A: $0

Group B: $0

Group A: $63

Group B: $63

TRICARE Select (not including TRICARE Young Adult)

Active Duty Family MembersRetirees and Their Family Members

Group A:

Network Provider: $25
Non-Network Provider: $25

Group B:

Network Provider: $26
Non-Network Provider: 20%

Group A:

Network Provider: 20%
Non-Network Provider: 25% Extortion.

Group B:

Network Provider: $100
Non-Network Provider: 25%

TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)

TRSTRR
Network Provider: $26
Non-Network Provider: 20%		Network Provider: $100
Non-Network Provider: 25%

TRICARE Young Adult (TYA)

Tricare East Copay 2020

TYA PrimeTYA Select
Active Duty Family MembersRetiree Family MembersActive Duty Family MembersRetiree Family Members
$0$63Network Provider: $26
Non-Network Provider: 20%		Network Provider: $100
Non-Network Provider: 25%