Point-of-Service Option

With the point-of-service option, you:

The point-of-service option doesn't apply to:

*If you visit a network provider in another region without a referral from your PCM, you're using the point-of-service option.

Point-of-Service Fees

When you use the point-of-service option, you’ll pay:

  • Point-of-service fees instead of your regular copayment
  • Any other fees charged by non-network providers

These fees don’t apply to your annual catastrophic cap.

Outpatient Deductible  Cost Shares 

You must pay this amount before cost sharing begins for outpatient services.

  • Individual: $300
  • Family: $600

Outpatient Services: 50% of TRICARE allowable chargeThe maximum amount TRICARE pays for each procedure or service.  This is tied by law to Medicare's allowable charges.

Hospitalization: 50% of TRICARE allowable charge

Last Updated 9/22/2017