Back to Top Skip to main content

Know your costs before making a choice during TRICARE Open Season

Take Command of your health Take Command of Your Health

Recommended Content:

TRICARE Health Program

TRICARE Open Season is underway. If you want to enroll in or change between TRICARE Prime and TRICARE Select health plans, you have until Dec. 10.

Active duty service members (ADSMs) are required to have TRICARE PrimeA managed care option available in Prime Service Areas in the United States; you have an assigned primary care manager who provides most of your care.TRICARE Prime health coverage. Active duty family members (ADFMs), retirees, and eligible retiree family members can choose to have either TRICARE Prime or TRICARE SelectStarting on January 1, 2018, TRICARE Select replaces TRICARE Standard and Extra. TRICARE Select is a self-managed, preferred provider network plan. TRICARE Select is a fee-for-service option in the United States that allows you to get care from any TRICARE-authorized provider.  Enrollment is required to participate. TRICARE Select coverage.

For many people, cost is a major factor in picking a health care plan. Before you choose a plan, make sure you know what’s covered and what it costs. To help you understand your potential health care costs, here are a few key TRICARE terms you should know.

  • TRICARE beneficiaries fall into one of two groups: Group A or Group B. Each group has different enrollment fees, deductibles, and out-of-pocket costs. You’re in Group A if your initial enlistment or appointment or that of your uniformed services sponsor began before Jan. 1, 2018. You’re in Group B if your initial enlistment or appointment or that of your uniformed services sponsor began on or after Jan. 1, 2018. When enrolled in TRICARE Reserve SelectA premium-based plan for qualified Selected Reserve members and their families.TRICARE Reserve Select, TRICARE Retired ReserveA preimum-based plan for qualified Retired Reserve members and their families.TRICARE Retired Reserve, TRICARE Young AdultA premium-based plan for qualified adult children.TRICARE Young Adult, or Continued Health Care Benefit Program follow Group B deductibles, copayments, cost-shares, and catastrophic caps regardless of when the uniformed services sponsor enlisted or was appointed.
  • An enrollment fee is the yearly amount you pay to enroll in TRICARE Prime or TRICARE Select. ADSMs and ADFMs don’t have an enrollment fee with TRICARE Prime. However, TRICARE Prime retirees, their families, and some others pay yearly enrollment fees. With TRICARE Select, ADFMs don’t pay enrollment fees, and neither do Group A retirees, their families, and others with TRICARE Select. However, Group B retirees, their families, and others pay yearly enrollment fees. Visit Health Plan Costs for more information.
  • A deductible is a fixed amount you pay for covered services each calendar year before TRICARE pays anything. You may have a deductible if you have TRICARE Select or if you have TRICARE Prime but see a provider without a referral.
  • A cost-share is a percentage of the total cost of a covered health care service that you pay after you pay your deductible.
  • A copayment is the fixed amount those with TRICARE Prime (who aren’t active duty) and TRICARE Select (for certain services) pay for a covered health care service or drug.
  • The catastrophic cap is the most you or your family will pay out of pocket for covered health care services each calendar year. When met, TRICARE pays your copayment or cost-share for covered health care services for the rest of the calendar year.
  • Point-of-service is an option under TRICARE Prime where you pay extra when getting nonemergency care from any TRICARE-authorized provider. The point-of-service option isn’t available to ADSMs.
  • The TRICARE-allowable charge is the maximum amount a participating TRICARE provider can be paid for a covered service. Learn more about TRICARE provider types.

Health care costs can differ based on who you are and your health plan option. For specific plan costs and dollar amounts, use the TRICARE Compare Cost Tool. Also, download the 2019 TRICARE Costs and Fees Sheet. If you want to enroll in or change your TRICARE health plan during TRICARE Open Season, take command of your health benefit by understanding your health care costs.

You also may be interested in...

Join July 25 TRICARE webinar on TRICARE coverage after retirement

Article
7/18/2019
Will you or a family member be retiring soon? If so, you don’t want to miss this month’s webinar. (U.S. Navy photo)

When you retire from active duty or retire from the National Guard or Reserve, your TRICARE coverage will change

Recommended Content:

TRICARE Health Program

Summer’s fun, just avoid too much sun

Article
6/25/2019
Soaking up the sun is one of the best parts about summer. However, make sure to protect your skin when enjoying the sun-filled days ahead. Too much unprotected exposure to the sun’s ultraviolet rays can cause sunburn, eye damage, and skin damage in the form of premature wrinkles. (DoD photo)

Make sure to protect your skin when enjoying the sun-filled days ahead

Recommended Content:

Summer Safety | TRICARE Health Program

Accreditation Status Table for MTFs

Report
6/13/2019

This document reports the status of accreditation for each MTF

Recommended Content:

TRICARE Health Program

Methodology Determination of 2020 Premium Rates for TRICARE Reserve Select

Policy

This document describes how the calendar year 2020 TRICARE Reserve Select (TRS) premium rates were calculated

Need a DS Logon? Step By Step Tutorial

Video
6/6/2019
Need a DS Logon? Step By Step Tutorial

This video describes how to find your Patient Portal TRICARE Online logon information

Recommended Content:

TRICARE Health Program | Military Health System Electronic Health Record | MHS GENESIS

Methodology Determination of 2020 Premium Rates for TRICARE Reserve Select

Publication
6/6/2019

This document outlines how Calendar Year (CY) 2020 TRICARE Reserve Select (TRS) premium rates were calculated

Recommended Content:

TRICARE Health Program

Memorandum to Establish 2020 Premium Rates for TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult, and the Continued Health Care Benefit Program

Policy

Calendar Year 2020 premium rates are established for TRICARE Reserve Select, TRICARE Retired Reserve, TRI CARE Young Adult, and Fiscal Year 2020 premium rates for the Continued Health Care Benefit Program.

Join May 30 webinar on TRICARE coverage for college students, young adults

Article
5/24/2019
Going to college is a big transition. It’s also a TRICARE Qualifying Life Event, which may open new enrollment opportunities for your student and other family members.

This webinar will discuss health care options for children moving away to college and those aging out of TRICARE

Recommended Content:

TRICARE Health Program

A change of address may mean new TRICARE health options

Article
5/16/2019
Moving may change the TRICARE health care options available to you and your family. A change of address, such as moving to a new country, city, region, or ZIP+4 code is a TRICARE Qualifying Life Event (QLE). This QLE means you have 90 days from the date of your address change to enroll in or change your TRICARE Prime or TRICARE Select health plan based on your eligibility or plan availability in the new location. (U.S. Navy photo)

Moving doesn’t change your TRICARE eligibility. But it may change the TRICARE health care options available to you and your family

Recommended Content:

TRICARE Health Program

Adding a new family member stateside? Take action to get TRICARE coverage

Article
5/3/2019
Take Command of Your Health

Whether giving birth or adopting, this change in your family composition is a TRICARE Qualifying Life Event

Recommended Content:

TRICARE Health Program

TRICARE Hurricane Disaster Infographic 2019

Infographic
5/2/2019
This infographic provides critical resources in the event a hurricane strikes

This infographic provides critical resources in the event a hurricane strikes

Recommended Content:

TRICARE Health Program

TRICARE Disaster Resources Infographic 2019

Infographic
5/2/2019
This infographic provides critical resources in the event a disaster strikes

This infographic provides critical resources in the event a disaster strikes

Recommended Content:

TRICARE Health Program

TRICARE Disaster Referral Waiver 2019

Infographic
5/2/2019
This infographic describes when a PCM waiver may be issues during a natural disaster

This infographic describes when a PCM waiver may be issues during a natural disaster

Recommended Content:

TRICARE Health Program

Continuing TRICARE health coverage after retirement

Article
4/25/2019
Take Command of Your Health

When you retire from active duty or turn age 60 as a retired reserve member, your TRICARE coverage changes

Recommended Content:

TRICARE Health Program

Study on the Treatment of TRICARE Beneficiaries who are Residents of Puerto Rico

Congressional Testimony
4/17/2019

HR 5515, NDAA Conference Report for FY 2019, 115-874, Pg. 896

Recommended Content:

TRICARE Health Program | Access to Health Care
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 10

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing: Download a PDF Reader or learn more about PDFs.