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Inpatient Cost-Shares Increase Slightly for Fiscal Year 2007 (Article 4) |
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Each fiscal year (Oct. 1–Sept. 30), some TRICARE inpatient cost-share rates increase slightly. The following tables highlight the new inpatient rates for fiscal year 2007.
For additional information about cost-shares for TRICARE-covered services, visit the TRICARE Web site. You can also call Humana Military at 1-800-444-5445 for more information.
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| Inpatient Rates at Civilian and Military Treatment Facilities |
| Program |
Active Duty Family Members |
Retirees, Their Families and Other Eligible Beneficiaries |
| TRICARE Prime |
No increase.
$0 per admission |
No increase.
$11 per day or $25 per admission, whichever is greater; no separate copayment for separately billed professional charges. |
| TRICARE Standard |
Increases from $14.35 to $14.80 per day or $25 per admission, whichever is greater. No charge for separately billed professional services. |
No increase.
$535 per day, or 25% of the total charge, whichever is less. Plus, 25% of the allowable charge for separately billed professional services. |
| TRICARE Extra |
Increases from $14.35 to $14.80 per day or $25 per admission, whichever is greater. No charge for separately billed professional service. |
No increase.
$250 per day or 25% of total charge, whichever is less. Plus, 20% of the allowable charge for separately billed professional services. |
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| Inpatient Rates for Behavioral Health at Civilian and Military Treatment Facilities |
| Program |
Active Duty Family Members |
Retirees, Their Families and Other Eligible Beneficiaries |
| TRICARE Prime |
No increase.
$0 per admission |
No increase.
$40 per day. No charge for separately billed professional charges. |
| TRICARE Standard |
No increase.
$20 per day or $25 per admission, whichever is greater. |
High Volume Hospitals—no increase—25% of hospital-specific charges.
Low Volume Hospital—increases from $175 to $181 per day or 25% of the billed charges, whichever is lower.
RTC— 25% of the allowed amount.
Partial hospitalization—25% of the allowed amount, plus 25% of the allowable charge for separately billed professional services.
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| TRICARE Extra |
No increase.
$20 per day or $25 per admission, whichever is greater. |
No increase.
20% of total charge. Plus, 20% of the allowable charge for separately billed professional services. |
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Created: March 21, 2007
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