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TRICARE Prime, TPR, and TPRADFM Health Care Costs
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The costs listed are for care received in civilian facilities. These costs are effective for fiscal year 2010 (October 1, 2009–September 30, 2010) and are subject to change each year on October 1.
Type of
Care
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ADSMs and ADFMs (TRICARE Prime, TPR, or TPRADFM)
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Retirees, Their Families, and All Others (TRICARE Prime)1
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Annual Deductible2
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$0 |
$0 |
Outpatient Visits
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$0 copayment per visit |
$12 copayment per visit |
Clinical Preventive Services
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$0 copayment per service |
$0 copayment per service |
Durable Medical Equipment (DME), Prosthetic Devices, and Medical Supplies
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$0 copayment |
20% of negotiated fee |
Hospitalization
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$0 per day |
$11 per day ($25 minimum charge)3 |
Emergency Services
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$0 copayment per visit |
$30 copayment per visit |
Outpatient Behavioral Health
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$0 copayment per visit |
$25 (individual visit)
$17 (group visit) |
Inpatient Behavioral Health
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$0 per day |
$40 per day |
Inpatient Skilled Nursing
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$0 per day per admission |
$11 per day ($25 minimum charge)3 |
1 The cost for inpatient care provided at a military treatment facility is $16.30 per day for retiree family members.
2 The annual deductible is $0 unless the POS option is used.
3 Example: If your stay lasts one or two days, your charge for the stay will be $25. If your stay lasts more than two days, your charge will be $11 multiplied by the number of days of your stay.
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