The point-of-service option (POS) allows you to receive non-emergency, TRICARE-covered services from any TRICARE-authorized provider without requesting a referral from your primary care manager, resulting in higher out of pocket costs. The POS option does not apply to:
- Active duty service members
- Newborns and adopted children during the first 60 days after birth or adoption
- Emergency care
- Clinical preventive care received from a network provider
- The first eight outpatient behavioral health care visits to a network provider per fiscal year (October 1-September 30)
- If you have other health insurance
Per fiscal year (October 1- September 30) for outpatient services.
- Individual $300
- Family $600
- Outpatient: 50% of TRICARE allowable charge (after annual deductible is met)
- Hospitalization: 50% of TRICARE allowable charge
You are responsible for any additional charges from non-network providers (up to 15% above the allowable charge is permitted by law). Point-of-service fees do not apply towards the annual catastrophic cap.