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News | Nov. 7, 2022

Preview 2023 TRICARE Health Plan Costs

By TRICARE Communications

Every year, TRICARE costs may change based on the law, the federal cost of living adjustment, changes in the cost of health care services and prescription drugs, and other factors. Depending on your TRICARE plan, you may see changes to your costs, including enrollment fees, premiums, cost-shares, and copayments next year.
 
“The Defense Health Agency is committed to providing quality health care to beneficiaries across the Military Health System,” said Dr. Danita Hunter, chief of TRICARE Policy and Programs. “The DHA is also committed to helping you make the right health decisions for you and your family. A big part of this is making sure you’re aware of and understand your health care costs with TRICARE.”  
 
Below is a list of the 2023 costs for TRICARE health plans. Changes from 2022 costs are in bold.
 
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. Premium-based health plans (TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult, and Continued Health Care Benefit Program) follow TRICARE Select Group B deductibles and applicable copayments or cost-shares.
 
Annual Enrollment Fees and Annual Deductibles
Active duty service members (ADSMs) and active duty family members (ADFMs) have no enrollment fees. Retirees, their family members, and most others must pay an annual enrollment fee for TRICARE 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 ADFMs enrolled in TRICARE Select or TRICARE Prime. TRICARE Prime includes TRICARE Prime Remote, the US Family Health Plan, and TRICARE Young Adult Prime. Changes from 2022 costs are in bold.
 
Table 1: Calendar Year 2023 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 $60 $0 $0
Family
(E-4 and below)
$100 $121 $0 $0
Individual
(E-5 and above)
$150 $182 $0 $0
Family
(E-5 and above)
$300 $365 $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 2022 costs are in bold.
 
Table 2: Calendar Year 2023 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 $171.96 $547.92 $351.96 $426
Family $345 $1,095.96 $703.92 $852
Annual deductible Individual $150 Network:
$182
Out-of-Network:
$365
$0 $0
Family $300 Network:
$365 
Out-of-Network:
$730
$0 $0
 
 
Out-of-pocket Costs (Copayments and Cost-shares)
ADSMs don’t have any out-of-pocket costs. If you’re an ADFM 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 ADFMs. Changes from 2022 costs are in bold.
 
Table 3: Calendar Year 2023 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 $1,217 $1,000 $1,217
Preventive care visit $0 $0 $0 $0
Primary care Network:
$25
Out-of-Network:
20%
Network:
$18
Out-of-Network:
20%
$0 $0
Specialty care Network:
$37
Out-of-Network:
20%
Network:
$30
Out-of-Network:
20%
$0 $0
Emergency room visit Network:
$103
Out-of-Network:
20%
Network:
$48
Out-of-Network:
20%
$0 $0
Urgent care center visit Network:
$25
Out-of-Network:
20%
Network:
$24
Out-of-Network:
20%
$0 $0
Ambulatory surgery Network and
Out-of-Network
$25
 
Network:
$30 
Out-of-Network:
20%
$0 $0
Ambulance, outpatient ground Network:
$75
Out-of-Network:
20%
Network:
$18
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 $21.30 per day;
$25 minimum per admission
Network:
$73 per admission;
Out-of-Network:
20%
$0 $0
Inpatient skilled nursing facility/rehab facility $21.30 per day;
$25 minimum per admission
Network:
$30 per day;
Out-of-Network:
$60 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. Changes from 2022 costs are in bold.
 
Table 4: Calendar Year 2023 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 $4,028 $4,262 $3,000 $4,262
Preventive care visit $0 $0 $0 $0
Primary care Network:
$34
Out-of-Network:
25%
Network:
$30 
Out-of-Network:
25%
$24 $24
Specialty care Network:
$49
Out-of-Network:
25%
Network:
$48
Out-of-Network:
25%
$36 $36
Emergency room visit Network:
$138
Out-of-Network:
25%
Network:
$97
Out-of-Network:
25%
$73 $73
Urgent care center visit Network:
$34
Out-of-Network:
25%
Network:
$48
Out-of-Network:
25%
$36 $36
Ambulatory surgery Network:
20%
Out-of-Network:
25%
Network:
$115
Out-of-Network:
25%
$73 $73
Ambulance, outpatient ground Network:
$100
Out-of-Network:
25%
Network:
$73
Out-of-Network:
25%
$48 $48
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 $213
per admission
$182
per  admission
$182
per admission
Out-of-Network ǂ$1,053/day up to 25% of hospital charges, plus 25% of separately billed services 25% $182
per  admission
$182
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:
$60 per day;
Out-of-Network: lesser of $365 per day or 20%
$36
per day
$36
per day
 
ǂThis is the 2022 rate. The 2023 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, you pay a monthly or quarterly premium.
 
Table 5 shows the monthly premiums for TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult Prime, and TRICARE Young Adult Select. Changes from 2022 costs are in bold.
 
Table 5: Calendar Year 2023 TRICARE Premium-Based Health Plans Monthly Premiums
 
Premium-based health plan Member Only Member and Family
TRICARE Reserve Select $48.47 $239.69
TRICARE Retired Reserve $549.35 $1,320.76
TRICARE Young Adult Prime $570 Not available
TRICARE Young Adult Select $291 Not available
 
Table 6 shows the quarterly premium for the Continued Health Care Benefit Program.
 
Table 6: Calendar Year 2023 TRICARE Premium-Based Health Plans Quarterly Premiums
 
Premium-based health plan Member Only Member and Family
Continued Health Care Benefit Program $1,654 $4,134
 
Want to review your costs from last year? Visit 2022 costs or go to the TRICARE costs tool.
 
This year, TRICARE Open Season runs from Nov. 14 to Dec. 13. This is the annual period when anyone enrolled in or eligible for TRICARE Prime, US Family Health Plan, or TRICARE Select can make changes to their health care coverage. If you want to learn more about open season, including how to change and compare health plans, go to the open season page. Any enrollment changes you make take effect on Jan. 1, 2023.
 
Would you like the latest TRICARE news sent to you by email? Visit the TRICARE Subscriptions page today, and create your personalized profile to get benefit updates, news, and more.
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