The maximum amount a TRICARE beneficiary pays each fiscal year depends on the type of coverage they have. Here are the details:
- TRICARE Select: You pay an annual deductible of $300 per individual or $600 per family before cost-sharing begins. For services beyond this deductible, you pay 50% of the TRICARE-allowable charge. These costs don’t apply to the catastrophic cap.
- TRICARE Reserve Select: The annual catastrophic cap is $1,044 for individual coverage and $3,408 for family coverage.
- TRICARE Retired Reserve: The annual catastrophic cap is $3,000 for all family members combined.
- TRICARE Young Adult: The catastrophic cap is $1,000 per year for all covered services.
- TRICARE Extended Care Health Option (ECHO): The coverage limit for all ECHO benefits combined, excluding the ECHO Home Health Care (EHHC) benefit, is $36,000 per year, per beneficiary. The EHHC benefit is capped annually at the maximum fiscal year amount TRICARE would pay if the beneficiary received the same care in a medical treatment facility?serv=128).
Its important to note that the catastrophic cap is the maximum out-of-pocket amount the beneficiary will pay each calendar year for TRICARE-covered services.
