TRICARE, Your Military Health Plan

In This Section:

• TRICARE Prime Options
• Enrollment Fees
• Network Copayments
• Point of Service Option
• TRICARE For Life
• TRICARE Standard and Extra
• TRICARE Standard Overseas
• TRICARE Reserve Select
• TRICARE Retired Reserve
• TRICARE Young Adult
• Prime Option
• Standard Option
• US Family Health Plan
• Enrollment Fees
• Network Copayments

Point-of-Service Option

The point-of-service option allows you to receive non-emergency, TRICARE-covered services from any TRICARE-authorized provider without requesting a referral from your primary care manager, resulting in higher out of pocket costs. The point-of-service option does not apply to:

• Active duty service members
• Newborns and adopted children during the first 60 days after birth or adoption
• Emergency care
• Clinical preventive care received from a network provider
• The first eight outpatient behavioral health care visits to a network provider per fiscal year (October 1-September 30)
• If you have other health insurance

Point-of-Service Fees

Outpatient Deductible per fiscal year (October 1- September 30)

• Individual $300
• Family $600

Cost Shares

• Outpatient: 50% of TRICARE allowable charge (after annual deductible is met)
• Hospitalization: 50% of TRICARE allowable charge

You are responsible for any additional charges from non-network providers (up to 15% above the allowable charge is permitted by law). Point-of-service fees do not apply towards the annual catastrophic cap:

Last Modified:May 30, 2012