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
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