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Costs for Care Overseas

These costs are effective 1/1/2018.
Service Cost
Annual Deductible Individual: $300
Family: $600
Ambulance Services

Network: $60

Out of network: 25%

Ambulatory Surgery (Same Day) 25% of allowable charge
Mental Health (Inpatient) See Mental Health Costs
Mental Health (Partial Hospitalization) See Mental Health Costs

Mental Health (Outpatient)

See Mental Health Costs
Clinical Preventive Services $0 for the following services:
  • Cancer screenings* (colorectal, breast, cervical, prostate)
  • Immunizations*
  • Well-child care for children under age 6 (birth through age 5)

*This includes the office visit for beneficiaries age 6 and older when a covered cancer screening or immunization is provided during the visit.

For all other preventive services: 25% of allowable charge

DME, Prosthetic Devices, Medical Supplies

Network: 20%

Out of network: 25%

Emergency Services

Network: $80

Out of network: 25% of allowable charge

Home Health Care

$0

Note: You may have separate costs for additional services when receiving home health care. For example, DME, drugs, vaccines, orthotics/prosthetics, and nutritional therapy, among others.

Hospice Care $0
Hospitalization (Inpatient Care)

Network: $175/admission 

Out of network: 25% of allowable charge

Immunizations $0
Laboratory and X-ray 25% of allowable charge
Maternity (office visits and hospitalization for delivery planned in a hospital in an inpatient setting)

Network Delivery: $175

Out of network: 25% of allowable charge

Maternity (office visits for delivery planning in a TRICARE-authorized birthing center)

Network delivery: $95

Out of network: 25%

Maternity (office visits for delivery planned at home or other setting)

Network: $25 (Primary) or $40 (Specialty) 

Out of network: 25%

Newborn Care

Network: $175 per admission

Out of network: 25% of allowable charge

Note: If any family member is enrolled in TRICARE Prime, the newborn is also covered by Prime for up to the first 90 days and costs are $0.

Outpatient Visit

Network: $25 (Primary) or $40 (Specialty) 

Out of network: 25% of allowable charge

Skilled Nursing (Inpatient)

Network: $50/day

Out of network: Lesser of $300 per day or 20% 

Only available in the U.S. and U.S. Territories.

Urgent Care

Network: $40

Out of network: 25%

Last Updated 11/30/2017