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TRICARE Retired Reserve Costs

Monthly Premiums

2014 Monthly Premiums
(through December 31, 2014) 
2015 Monthly Premiums
(beginning January 1, 2015) 
  • Member Only: $390.99 per month
  • Member and Family: $956.65 per month
  • Member Only: $390.89 per month
  • Member and Family: $961.35 per month

If you use TRICARE Retired Reserve, you'll pay for the full cost of coverage. By law, there is no government subsidy.

First Premium Payment

You'll pay an initial two-month premium payment when you first enroll, which can be paid by:

  • Check
  • Money order or cashier's check (payable to the regional contractor)
  • Debit/credit card (Visa or MasterCard)

Ongoing Premium Payments

After your first payment, premiums are paid by:

  • Automatic payment through an electronic funds transfer (EFT)
  • Recurring debit/credit card (Visa or MasterCard)

Your regional contractor will automatically process your premium payments on the first business day of the month. This will cover your care for that month.

  • You may be charged a fee of up to $20.00 for insufficient or unavailable funds
  • If you don't pay any overdue premium amounts, your coverage will be suspended as of the last day of the month last paid

Payment Options

Learn more about your payment options in your region:

Annual Outpatient Deductible

You must meet the annual outpatient deducible each fiscal year before TRICARE begins to pay. The fiscal year starts on October 1.

  • $150 per individual
  • $300 per family

Cost Shares

You'll pay a cost share based on the type of care provider you see (network vs. non-network). Non-network providers may charge up to 15% more than the TRICARE allowable charge. You're responsible for these extra charges. 

Some inpatient cost shares will change each fiscal year, starting October 1. The costs below start October 1, 2013.

Type of Care Network Non-Network
Ambulatory Care (Same Day Surgery) 20% of the negotiated rate 25% of the allowable charge
Behavioral Health

Inpatient: 20% of the total charge, plus 20% for separately billed services

Outpatient: 20% of the negotiated rate

Inpatient:

  • High Volume Hospital-25% of the hospital-specific per diem
  • Low Volume Hospital-$218 per day or 25% of the billed charges, whichever is less

Outpatient: 25% of the allowable charge

Home Health Care     $0 $0
Hospice Care $0 $0

Hospitalization

 

$250 per day or 25% of billed charges, whichever is less, plus 20% for separately billed services.

$744 per day or 25% of billed charges, whichever is less, plus 25% for separately billed services.

Maternity Care

Global fee for office visits & 
hospitalization for delivery 
planned in a hospital: $250 per day or 25% of billed charges, whichever is less, plus 20% for separately billed services

Office visits for delivery planned in a birthing center, home or other setting: 20% of the negotiated rate

Global fee for office visits & 
hospitalization for delivery 
planned in a hospital: $744 per day or 25% of billed charges, whichever is less, plus 25% for separately billed services.

Office visits for delivery planned in a birthing center, home or other setting: 25% of the allowable charge

Newborn Care

The lower of the number of hospital days minus 3 multiplied by $250 or 25% of the negotiated rate, plus 20% for separately billed professional charges.

The lower of the number of hospital days minus 3 multiplied by DRG per diem copayment or 25% of billed charges, plus 25% for separately billed professional charges.

Outpatient Services (which include):  
20% of the negotiated rate 25% of the allowable charge
Skilled Nursing Care (Inpatient)**

$250 per day or 25% of billed charges, whichever is less, plus 20% for separately billed services.

25% of billed charges, whichever is less, plus 25% for separately billed services.

*The following Preventive Services are available free of charge: colorectal, breast, cervical and prostate cancer screenings; immunizations; and well-child visits for children under age 6.

**Skilled Nursing is only available in the U.S. and U.S. Territories.

Last Updated 10/7/2014

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