TRICARE Standard Overseas
TRICARE Standard Overseas costs vary depending on the sponsor's military status (active duty vs. retired).
Annual Outpatient Deductible
You must meet the annual outpatient deducible each fiscal year (October 1 - September 30) before cost-sharing begins:
- Active duty sponsor Rank E4 and below: $50 per individual/$100 per family
- Active duty sponsor Rank E5 and above: $150 per individual/$300 per family
- All others: $150 per individual/$300 per family
The annual outpatient deductible is waived for family members of National Guard/Reserve members who are called to active duty for more than 30 days in support of a contingency operation.
Cost Shares
You're responsible to pay a cost share based on the type of care and where its received.
Costs effective October 1, 2011
|
Type of Care |
Cost Share |
|
|
Active Duty Family Members* |
All Others |
|
|
Ambulance Services |
20% of the allowable charge |
25% of the allowable charge |
|
Ambulatory (same day) Surgery |
$25 per visit |
25% of the allowable charge |
|
Behavioral Health |
Outpatient:
Hospitalization:
|
Outpatient:
Hospitalization:
|
|
Clinical Preventive Services $0 for colorectal, breast, cervical and prostate cancer screenings; immunizations; and well-child visits for children under age 6. For all other preventive services: |
20% of the allowable charge |
25% of the allowable charge |
|
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies |
20% of the allowable charge |
25% of the allowable charge |
|
Emergency Room Visit |
20% of the allowable charge |
25% of the allowable charge |
|
Hospitalization |
$17.05 per day ($25 minimum) |
$708 per day or 25% of billed charges for institutional services, whichever is less, plus 25% cost-share for separately billed services |
|
Lab & X-Ray Services |
20% of the allowable charge |
25% of the allowable charge |
|
Maternity Care |
Office visits & hospitalization for delivery planned in a hospital in an inpatient setting. This is one global fee.
Office visits for delivery planned in a TRICARE-authorized birthing center.
Office visits for delivery planned at home or another setting.
|
Office visits & hospitalization for delivery planned in a hospital in an inpatient setting. This is one global fee.
Office visits for delivery planned in a TRICARE-authorized birthing center, at home or another setting.
|
|
Newborn Care |
$0 as the newborn is enrolled in TRICARE Prime for up to the first 120 days. |
The lower of the number of hospital days minus 3 multiplied by DRG per diem copayment or 25% of billed charges for institutional services, plus 25% for separately billed professional charges. |
|
Outpatient Visit |
20% of the allowable charge |
25% of the allowable charge |
|
Skilled Nursing Care |
$17.05 per day ($25 minimum) |
25% for institutional services, plus 25% cost share for separately billed professional charges |
*Includes family members of activated National Guard/Reserve Members.
Last Modified:May 30, 2012
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