Bread Crumbs

Health Plan Costs for Calendar Year 2018

Starting on January 1, 2018, you will fall into one of two categories based on when you or your sponsor entered active duty. Each group will have different enrollment fees and out-of-pocket costs. 

Changes

All enrollees: Costs for TRICARE benefits will be charged by Calendar Year (January - December) instead of Fiscal YearOctober 1 - September 30 (October - September). 

If you are in a plan now that requires enrollment fees, you will need to continue paying enrollment fees during the three months between October 1 and December 31, 2017. We will pro-rate enrollment fees based on the 2017 rates and will send you information on how much you will need to pay to cover the final three months of the calendar year.*

Group AIf you or your sponsor’s initial enlistment or appointment occurred before January 1, 2018, you are in Group A.: If you or your sponsor’s initial enlistment or appointment occurred before January 1, 2018, you are in Group A.

Group BIf you or your sponsor’s initial enlistment or appointment occurs on or after January 1, 2018, are in Group B.: If you or your sponsor’s initial enlistment or appointment occurs on or after January 1, 2018, are in Group B.

 

 * We will extend deductibles and catastrophic caps that usually reset on October 1 through the end of the calendar year. Any enrollment fees you pay during this transition period will continue to count against the catastrophic cap until it resets on January 1, 2018. This means that if you reach your fiscal year 2017 catastrophic cap, you will not have additional out-of-pocket costs for authorized TRICARE-covered services for the last three months of calendar year 2017.

Automatic Payments 

If you pay by allotment, the enrollment fees will continue to be paid automatically, and you will not need to do anything. Unless you cancel your allotment, we will continue to deduct enrollment fees starting January 1, 2018.

If you pay by electronic fund transfer and are in an area where a new contractor will be delivering services, we will send you information on how to update your payment to go to the new contractor. 

TRICARE For Life

Costs won’t change for TRICARE For Life (TFL). Also, there are no changes in TFL eligibility, benefits, or the requirement to have Medicare Part A and B. 

Premium Based Plans

These plans include:

  • TRICARE Young Adult (TYA)
  • TRICARE Retired Reserve (TRR)
  • TRICARE Reserve Select (TRS)
  • Continued Health Care Benefit Program (CHCBP)

If you have a premium based plan, you will continue to see your yearly premiums adjusted each year on January 1 the way they have been in the past. These yearly adjustments are required by law, and will be calculated the same way they are today. We will add copay and cost share information to this page as soon as it’s available. >>Sign up for Email Updates.

Using TRICARE overseas

You can continue to use TRICARE in overseas areas. In some areas, TRICARE will build a preferred provider network. In other areas, you will pay the out-of-network cost share amounts for TRICARE Select. We will add copay and cost share information to this page as soon as it’s available. >>Sign up for Email Updates.

Active Duty Family Members (ADFM)

Are you an Active Duty Family Member using a TRICARE Prime plan or a TRICARE Select plan? 

You won’t pay an annual enrollment fee, but you may have to pay copays or cost-shares when you get care outside of the military treatment facility. Regardless of plan, your family catastrophic cap will be $1,000 each year. If you use TRICARE Select, you will also have individual and family deductibles.

If you’re in TRICARE Prime and choose to get specialty care without referral or authorization, that is our point-of-service (POS) option. With POS, you will have to pay the deductible and 50% of the cost for your TRICARE covered treatment. Any deductibles or cost-shares for POS don’t count toward your catastrophic cap.

We will add copay and cost share information to this page as soon as it’s available. >>Sign up for Email Updates. 

Costs for Active Duty Family Members

 

Select Group A

 

Select Group B

 

Prime Group A

 

Prime Group B

 

Annual Enrollment

 

$0

 

$0

 

$0

 

$0

 

Annual Deductible

 

E1-E4: $50 for individual and $100 for family.
E5 and above: $150 for individual and $300 for family

 

E1-E4: $50 for individual and $100 for family.
E5 and above: $150 for individual and $300 for family

 

$0

 

$0

 

Annual Catastrophic Cap

 

$1,000

 

$1,000

 

$1,000

 

$1,000

 

Point Of Service Option Deductible

 

N/A

 

N/A

 

$300 for individual and $600 for family

 

$300 for individual and $600 for family

 

Retired Service Members, Their Families and All Others

Are you a retired Service member or their family? Or are you using any of the premium-based plans?

You may pay an enrollment fee depending on your group and your plan. You may also have deductibles, copays and cost-shares. Regardless of plan, you will be protected by a catastrophic cap.

If you’re in TRICARE Prime and choose to get specialty care without referral or authorization, that is our point-of-service (POS) option. With POS, you will have to pay the deductible and 50% of the cost for your TRICARE covered treatment. Any deductibles or cost-shares for POS don’t count toward your catastrophic cap.

We will add copay and cost share information to this page as soon as it’s available.
>>Sign up for Email Updates.

Costs for Retirees, Retiree Family, and Other Plan Users
(Excluding TFL)

 

Select
Group A

 

Select
Group B

 

Prime
Group A

 

Prime
Group B

 

Annual Enrollment

 

$0

 

$450 for individual or $900 for families

 

*Current rates will be adjusted by COLA increase on January 1

 

$350 for individual or $700 for families

 

Annual Deductible

 

$150 for individual and $300 per family

 

Network providers will be $150 for individual and $300 per family. Out of network will be $300 for individual and $600 per family

 

$0

 

$0

 

Annual Catastrophic Cap

 

$3,000

 

$3,500

 

$3,000

 

$3,500

 

Point Of Service Option Deductible

 

N/A

 

N/A

 

$300 for individual and $600 for family

 

$300 for individual and $600 for family

 

* Prime Group A enrollment fees are adjusted every year by the cost of living adjustment to retired pay. In 2017, annual enrollment rates were $282.60 for individuals and $565.20 for families. When the COLA is announced later this year, we will update this chart to show the January 1 enrollment fee for Prime Group A.

 

Last Updated 8/31/2017