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Catastrophic Cap


The TRICARE catastrophic cap limits your out-of-pocket expenses on annual deductibles, cost-shares, and other costs (such as those for pharmacy) for TRICARE-covered medical services and supplies. As a TRICARE beneficiary, you will not be responsible for any cost-shares over the catastrophic cap total in a given fiscal year (October 1–September 30). Refer to the TRICARE: Summary of Beneficiary Costs flyer for the catastrophic cap by beneficiary category.

Note: The catastrophic cap does not apply to services that are not covered or to the additional 15 percent that nonparticipating providers may charge above the TRICARE allowable charge or POS charges.
 
Last Reviewed: February 19, 2010