FALLS CHURCH, Va. –
The 2023 TRICARE health plan costs are available.
The New Year is almost here. This means annual cost changes for most TRICARE health plans, starting Jan. 1. Cost changes reflect decisions made by Congress, cost-of-living adjustments, changes to the cost of health care services and drugs, and more. This affects enrollment fees and premiums for some individuals, as well as certain out-of-pocket costs.
Knowing the 2022 costs will help you prepare for
TRICARE Open Season, which runs from Nov. 8 to Dec. 13. Even if you keep your current health plan next year, you should check for any cost changes that will affect you.
TRICARE
beneficiaries fall into one of two groups: Group A or Group B. What group you’re in determines your enrollment fees or premiums and any other per service out-of-pocket costs that you may have with your TRICARE plan. See your group below:
- You’re in Group A if your initial enlistment or appointment or that of your uniformed service sponsor began before Jan. 1, 2018.
- You’re in Group B if your initial enlistment or appointment or that of your uniformed service sponsor began on or after Jan. 1, 2018.
When enrolled in
TRICARE Reserve Select,
TRICARE Retired Reserve,
TRICARE Young Adult, or the
Continued Health Care Benefit Program, you follow TRICARE Select Group B deductibles and applicable copayments or cost-shares.
Below is a list of the 2022 costs for TRICARE health plans. Changes from 2021 costs are in
bold.
Annual Enrollment Fees and Annual Deductibles
Active duty service members and active duty family members continue to have no enrollment fees. Retirees, their family members, and most others must pay an annual enrollment fee for their coverage. If you have
TRICARE Prime, there’s no annual deductible. If you have
TRICARE Select, you must spend your deductible before TRICARE cost-sharing begins.
Table 1 shows the annual enrollment fee and annual deductible for active duty family members enrolled in TRICARE Select or TRICARE Prime. TRICARE Prime includes
TRICARE Prime Remote, the
US Family Health Plan, and
TRICARE Young Adult Prime plans. Changes from 2021 costs are in bold.
Table 1: Calendar Year 2022 TRICARE Prime and TRICARE Select Out-of-Pocket Costs: Active Duty Family Members
| Out-of-pocket Cost |
TRICARE Select |
TRICARE Prime |
| Group A |
Group B |
Group A |
Group B |
| Annual enrollment fee |
Individual |
$0 |
$0 |
$0 |
$0 |
| Family |
$0 |
$0 |
$0 |
$0 |
| Annual deductible |
Individual
(E-4 and below) |
$50 |
$56 |
$0 |
$0 |
Family
(E-4 and below) |
$100 |
$112 |
$0 |
$0 |
Individual
(E-5 and above) |
$150 |
$168 |
$0 |
$0 |
Family
(E-5 and above) |
$300 |
$336 |
$0 |
$0 |
Table 2 shows the annual enrollment fee and annual deductible for retirees, their family members, and others enrolled in TRICARE Select or TRICARE Prime. Changes from 2021 costs are in bold.
Table 2: Calendar Year 2022 TRICARE Prime and TRICARE Select Out-of-Pocket Costs: Retired Service Members, Their Families, and Others
| Out-of-pocket Cost |
TRICARE Select |
TRICARE Prime |
| Group A |
Group B |
Group A |
Group B |
| Annual enrollment fee |
Individual |
$158 |
$504 |
$323 |
$392 |
| Family |
$317 |
$1,008 |
$647 |
$784 |
| Annual deductible |
Individual |
$150 |
Network:
$168
Out-of-Network:
$336 |
$0 |
$0 |
| Family |
$300 |
Network:
$336
Out-of-Network: $672 |
$0 |
$0 |
Out-of-pocket Costs (Copayments and Cost-shares)
ADSMs don’t have any out-of-pocket costs. If you’re an active duty family member enrolled in a TRICARE Prime plan, you won’t have copayments unless you’re using the
point-of-service option or filling a prescription outside of a
military pharmacy.
Table 3 shows TRICARE Select and TRICARE Prime network and out-of-network out-of-pocket costs for active duty family members. Network means a provider in the TRICARE network. Out-of-network means a TRICARE-authorized provider not in the TRICARE network. Changes from 2021 costs are in bold.
Table 3: Calendar Year 2022 TRICARE Prime and TRICARE Select Out-of-Pocket Costs: Active Duty Family Members
| Out-of-pocket Cost |
TRICARE Select |
TRICARE Prime |
| Group A |
Group B |
Group A |
Group B |
| Annual catastrophic cap |
$1,000 |
$1,120 |
$1,000 |
$1,120 |
| Preventive care visit |
$0 |
$0 |
$0 |
$0 |
| Primary care |
Network:
$24
Out-of-Network:
20% |
Network:
$16
Out-of-Network:
20% |
$0 |
$0 |
| Specialty care |
Network:
$38
Out-of-Network:
20% |
Network:
$28
Out-of-Network:
20% |
$0 |
$0 |
| Emergency room visit |
Network:
$99
Out-of-Network:
20% |
Network:
$44
Out-of-Network:
20% |
$0 |
$0 |
| Urgent care center visit |
Network:
$24
Out-of-Network:
20% |
Network:
$22
Out-of-Network:
20% |
$0 |
$0 |
| Ambulatory surgery |
$25
Network and Out-of-Network |
Network:
$28
Out-of-Network:
20% |
$0 |
$0 |
| Ambulance, outpatient ground |
Network:
$74
Out-of-Network:
20% |
Network:
$16
Out-of-Network:
20% |
$0 |
$0 |
| Ambulance, outpatient air |
Network and Out-of-Network:
20% |
Network and Out-of-Network:
20% |
$0 |
$0 |
| Durable medical equipment |
Network: 15%
Out-of-Network:
20% |
Network: 10%
Out-of-Network:
20% |
$0 |
$0 |
| Inpatient admission |
$20.75 per day; $25 minimum per admission |
Network:
$67 per admission;
Out-of-Network: 20% |
$0 |
$0 |
| Inpatient skilled nursing facility/rehab facility |
$20.75 per day; $25 minimum per admission |
Network:
$28 per day;
Out-of-Network: $56 per day |
$0 |
$0 |
Note: The costs for maternity (delivery and inpatient) are the same costs for inpatient admission. The costs for mental health (inpatient) are the same costs for inpatient admission. Mental health (primary care) follow the same costs as for primary care. Mental health (specialty care) follow the same costs as for specialty care.
Table 4 shows TRICARE Select and TRICARE Prime network and out-of-network out-of-pocket costs for retirees, their families, and all others. Network means a provider in the TRICARE network. Out-of-network means a TRICARE-authorized provider not in the TRICARE network. Changes from 2021 costs are in bold.
Table 4: Calendar Year 2022 TRICARE Prime and TRICARE Select Out-of-Pocket Costs: Retirees, their Families, and all Others
| Out-of-pocket Cost |
TRICARE Select |
TRICARE Prime |
| Group A |
Group B |
Group A |
Group B |
| Annual catastrophic cap |
$3,706 |
$3,921 |
$3,000 |
$3,921 |
| Preventive care visit |
$0 |
$0 |
$0 |
$0 |
| Primary care |
Network:
$32
Out-of-Network:
25% |
Network:
$28
Out-of-Network: 25% |
$22 |
$22 |
| Specialty care |
Network:
$50
Out-of-Network:
25% |
Network:
$44
Out-of-Network:
25% |
$33 |
$33 |
| Emergency room visit |
Network:
$133
Out-of-Network:
25% |
Network:
$89
Out-of-Network:
25% |
$67 |
$67 |
| Urgent care center visit |
Network:
$32
Out-of-Network:
25% |
Network:
$44
Out-of-Network:
25% |
$33 |
$33 |
| Ambulatory surgery |
Network:
20%
Out-of-Network:
25% |
Network:
$106
Out-of-Network:
25% |
$67 |
$67 |
| Ambulance, outpatient ground |
Network:
$99
Out-of-Network:
25% |
Network:
$67
Out-of-Network:
25% |
$44 |
$44 |
| Ambulance, outpatient air |
Network and Out-of-Network: 25% |
Network and Out-of-Network: 25% |
$20 |
$20 |
| Durable medical equipment |
Network:
20%
Out-of-Network:
25% |
Network:
20%
Out-of-Network:
25% |
20% |
20% |
| Inpatient admission |
Network |
$250/day up to 25% of hospital charges, plus 20% of separately billed services |
$196
per admission |
$168
per admission |
$168
per admission |
| Out-of-Network |
ǂ $1,034/day up to 25% of hospital charges, plus 25% of separately billed services |
25% |
$168
per admission |
$168
per admission |
| Inpatient skilled nursing facility/rehab facility |
Network: $250/day up to 25% of hospital charges, plus 20% of separately billed services;
Out-of-Network: 25% |
Network:
$56 per day;
Out-of-Network: lesser of $336 per day or 20% |
$33
per day |
$33
per day |
ǂ This is the 2021 rate. The 2022 out-of-pocket expense will be available mid-December once the diagnosis-related group payment rates are calculated.
Note: The costs for maternity (delivery and inpatient) are the same costs for inpatient admission. The costs for mental health (inpatient) are the same costs for inpatient admission. Mental health (primary care) follow the same costs as for primary care. Mental health (specialty care) follow the same costs as for specialty care.
Premiums
When enrolled in a premium-based health plan (TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult Prime, TRICARE Young Adult Select, or Continued Health Care Benefit Program), you pay a monthly or quarterly premium.
Table 5 shows the monthly premium for TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult Prime, and TRICARE Young Adult Select. Changes from 2021 costs are in bold.
Table 5: Calendar Year 2022 TRICARE Premium-Based Health Plans Monthly Premiums
| Premium-based health plan |
Member Only |
Member and Family |
| TRICARE Reserve Select |
$46.70 |
$229.99 |
| TRICARE Retired Reserve |
$502.32 |
$1,206.99 |
| TRICARE Young Adult Prime |
$512 |
Not available |
| TRICARE Young Adult Select |
$265 |
Not available |
If you have the Continued Health Care Benefit Program, you pay a quarterly premium.
Table 6: Fiscal Year 2022 TRICARE Premium-Based Health Plans Quarterly Premiums (Oct. 1, 2021–Sept. 30, 2022)
| Premium-based health plan |
Member Only |
Member and Family |
| Continued Health Care Benefit Program |
$1,654 |
$4,079 |
Looking for more on costs? Visit
TRICARE Cost Terms for definitions. To see current costs, check out the
TRICARE Compare Cost Tool. Your
TRICARE contractor is also available to help if you have questions about
how your TRICARE plan works.