TRICARE Costs: 2026 Fee Guide & Rates | TRICARE.com

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## Quick answer TRICARE costs depend on who you are (your "beneficiary group"), which plan you choose, and your sponsor's military status. Active duty service members generally pay $0 out-of-pocket, while retirees and family members may pay annual enrollment fees, deductibles, and fixed copayments or percentage-based cost-shares.

In detail

Understanding TRICARE costs requires knowing your **Beneficiary Group**. Group A consists of those whose sponsor joined before Jan. 1, 2018. Group B consists of those whose sponsor joined on or after Jan. 1, 2018.

### 1. Annual Enrollment Fees If you are an active duty service member (ADSM) or active duty family member (ADFM) on TRICARE Prime, you pay **$0 in enrollment fees**. * **TRICARE Prime (Retirees):** For 2026, retirees in Group A pay approximately $391 per individual or $782 per family annually. Group B retirees pay higher rates. * **TRICARE Select:** ADFMs pay no enrollment fee. Retirees pay an annual fee (2026 rates for Group A are approximately $183/individual and $366/family).

### 2. Deductibles The deductible is the amount you pay out-of-pocket before TRICARE begins to share the cost. * **TRICARE Prime:** No deductible for network care. * **TRICARE Select (ADFMs):** For 2026, E-4 and below pay $62/individual; E-5 and above pay $188/individual. * **Point-of-Service (POS):** If you have Prime but see a provider without a referral, you face a $300 individual / $600 family deductible.

### 3. Out-of-Pocket Costs (Copays & Cost-Shares) Once deductibles are met, you pay a specific amount per visit. * **Primary Care:** Typically $0 for Prime; ~$30–$40 for Select (Group A retirees). * **Specialty Care:** Typically $0 for Prime; ~$50–$60 for Select (Group A retirees). * **Emergency Room:** Varies significantly; ~145–$250 for retirees depending on the plan.

### 4. Pharmacy Costs Managed by **Express Scripts**, pharmacy costs are standardized across all plans: * **Military Pharmacy:** $0 for a 90-day supply. * **Home Delivery (Tier 1 Generic):** ~$16 for a 90-day supply (2026 rates). * **Retail Network (Tier 1 Generic):** ~$18 for a 30-day supply (2026 rates).

### 5. Catastrophic Cap The Catastrophic Cap is the most you will pay out-of-pocket for covered TRICARE services in a calendar year. * **Active Duty Families:** $1,000–$1,288 depending on Group. * **Retirees:** $4,000–$4,399+ depending on Group and plan type.

## Who this applies to * **Active Duty Service Members:** Pay $0 for all authorized medical care. * **Active Duty Family Members:** Pay $0 on Prime; low deductibles and cost-shares on Select. * **Retirees & Families:** Responsible for annual enrollment fees and higher cost-shares. * **National Guard/Reserve:** Pay monthly premiums for TRICARE Reserve Select (TRS) or TRICARE Retired Reserve (TRR).

Common scenarios

**Scenario 1: The Active Duty Spouse (TRICARE Select)** Jane is married to an E-6. She uses TRICARE Select. In 2026, she pays $0 in enrollment fees. She spends $188 to meet her deductible. Afterward, she pays a $32 copay for a visit to a network primary care doctor.

**Scenario 2: The Retired Individual (TRICARE Prime)** John retired in 2010 (Group A). In 2026, he pays $391 for his annual enrollment fee. Because he stays in-network and gets referrals, he pays $0 for his doctor visits and $0 for his prescriptions filled at the base pharmacy.

**Scenario 3: The Out-of-Network Emergency** Sarah is on TRICARE Select. She visits an out-of-network emergency room. She is responsible for her deductible, plus a 25% cost-share of the TRICARE allowable amount, plus any "balance billing" amounts up to 15% above the allowable rate.

## Related terms * **Catastrophic Cap:** The maximum annual out-of-pocket limit for covered services. * **Cost-Share:** A percentage of the total cost of a service that the beneficiary pays (common in TRICARE Select). * **Copayment:** A fixed dollar amount paid for a specific service (common in TRICARE Prime). * **Allowable Charge:** The maximum amount TRICARE will pay for a specific medical service. * **Premium:** A monthly recurring cost to maintain coverage (primarily for TRS, TRR, and TYA).

## Sources * TRICARE.mil Costs: https://www.tricare.mil/costs * Defense Health Agency (DHA): https://health.mil/ * Humana Military (East): https://www.humanamilitary.com/ * TriWest Healthcare Alliance (West): https://www.triwest.com/