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TRICARE Young Adult Prime Costs

Monthly Premiums

The current premium though December 2014 is:

  • $180 per month

Paying Monthly Premiums

You must submit a two-month premium payment with your completed form to start. Your first premium payment can be paid by:

  • Check
  • Money order or cashier's check (payable to your regional contractor)
  • Debit or credit card (Visa or Mastercard)

After your first payment, you must pay your premiums by:

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

Copayments

Active Duty Sponsors

If you're the child of an active duty service member:

  • You pay nothing out-of-pocket for any type of care
  • Unless you get care without a referral, then you will pay point-of-service charges

Retired Sponsors

If you're the child of a retired service member:

  • You pay the copayments below for care from TRICARE network provider
  • If you get care without a referral, then you'll pay point-of-service charges
  • Your costs are for care from civilian primary care managers (PCMs) or for care received with a PCM referral, when required.
Type of Care  Cost 
Ambulance Services $20 per occurance
Ambulatory (Same Day) Surgery  $25 per visit 
Behavioral Health

Outpatient:

  • $25 (individual visit)
  • $17 (group visit)

Inpatient: $40 per day (no charge for separately billed professional charges)

Clinical Preventive Services  $0
Durable Medical Equipment, Prosthetics, Orthotics & Supplies  20% of the negotiated fee
Emergency Room Visit  $30 per visit
Home Health Care $0
Hospice Care  $0
Hospitalization  $11 per day ($25 minimum)
Lab & X-Ray Services $12 per visit (unless billed as a clinical preventive service)
Maternity Care

Global fee for office visits and hospitalization for delivery in a hosptial as an inpatient: $11 per day ($25 minimum)

Office visists for delivery planned in a TRICARE-authorized birthing center: $25 per visit

Office visits for delivery planned at home or another setting: $12 per visit

Newborn Care $11 per day ($25 minimum)
Outpatient Visit  $12 per visit
Skilled Nursing Care $11 per day ($25 minimum)

Last Updated 5/21/2014

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