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Costs for Inpatient Services Increase Slightly
New Rates Effective Oct. 1, 2008, through Sept. 30, 2009
Each fiscal year, costs for TRICARE-covered inpatient services are subject to change. The following tables highlight the new rates for inpatient services for fiscal year 2009 (Oct. 1, 2008–Sept. 30, 2009).*
For additional information about copayments and cost-shares for TRICARE-covered services, visit the TRICARE Web Site. You can also contact Humana Military for more information. * While the inpatient rate increases are technically effective Oct. 1, 2008, there may be some delay between then and the time Humana Military receives direction from the TRICARE Management Activity and can implement the change.
Beneficiary Out-of-Pocket Costs for Inpatient Services for Civilian Hospital Admissions
|
Program Option
|
Active Duty Family Members
|
Retirees, Their Families and Other Eligible Beneficiaries
|
| TRICARE Prime |
(no change)
$0 per admission |
(no change)
$11 per day or $25 per admission, whichever is greater; no charge for separately billed professional services |
| TRICARE Standard |
Increases from $15.15 to $15.65 per day or $25 per admission, whichever is greater; no charge for separately billed professional services |
(no change)
$535 per day or 25% of the total charge, whichever is less, plus 25% of the TRICARE-allowable charge for separately billed professional services |
| TRICARE Extra |
Increases from $15.15 to $15.65 per day or $25 per admission, whichever is greater; no charge for separately billed professional services |
(no change)
$250 per day or 25% of the total charge, whichever is less, plus 20% of the TRICARE-allowable charge for separately billed professional services |
Beneficiary Out-of-Pocket Costs for Inpatient Behavioral Health Services for Civilian Hospital Admissions
|
Program Option
|
Active Duty Family Members
|
Retirees, Their Families and Other Eligible Beneficiaries
|
| TRICARE Prime |
(no change)
$0 per admission |
(no change)
$40 per day; no charge for separately billed professional services |
| TRICARE Standard |
(no change)
$20 per day or $25 per admission, whichever is greater |
High-Volume Hospitals (no change): 25% of hospital-specific charges
Low-Volume Hospitals: Increases from $187 to $193 per day or 25% of the billed charges, whichever is less
Residential Treatment Center (no change): 25% of the TRICARE-allowable charge
Partial Hospitalization (no change): 25% of the TRICARE-allowable charge, plus 25% of the TRICARE-allowable charge for separately billed professional services |
| TRICARE Extra |
Increases from $15.15 to $15.65 per day or $25 per admission, whichever is greater; no charge for separately billed professional services |
(no change)
20% of the total charge, plus 20% of the TRICARE-allowable charge for separately billed professional services |
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