TRICARE Emergency Room Costs: 2026 Copays & Rules | TRICARE.com

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## Quick answer Active duty service members pay $0 for emergency room visits. For all other beneficiaries, costs depend on your plan and sponsor status, ranging from a $0 copay for TRICARE Prime to approximately $100–$250 for TRICARE Select and TRICARE Reserve Select. Always call 911 or go to the nearest emergency room if you have a life-threatening emergency.

Details

### Emergency vs. Urgent Care TRICARE defines an emergency as a medical condition that "threatens life, limb, or sight." If you visit an ER for a non-emergency issue (like a sore throat or minor rash) and you are on a Prime plan, you may be charged under the Point-of-Service (POS) option, which carries a much higher deductible and 50% cost-sharing.

### 2026 Emergency Room Costs by Plan Costs are determined by whether the sponsor is Active Duty or Retired, and which "Group" they fall into (Group A joined before 2018; Group B joined on or after Jan. 1, 2018).

* **TRICARE Prime (All Categories):** $0 copay (assuming the visit is a true emergency). * **TRICARE Select (Active Duty Family Members):** * Group A: ~$33 per visit (2026 rate). * Group B: ~$31 per visit (2026 rate). * **TRICARE Select (Retirees & Families):** * Group A: ~$166 per visit (2026 rate). * Group B: ~$104–$208 per visit (varies by network status). * **TRICARE Reserve Select (TRS):** ~$31 per visit (2026 rate). * **TRICARE Retired Reserve (TRR):** ~$104–$208 per visit (2026 rate).

### The Rule on ER Admissions If you are admitted to the hospital directly from the emergency room, the ER copay is usually waived. You will instead pay the applicable inpatient hospital cost-share for your specific plan.

### Follow-up Requirements If you are enrolled in a **TRICARE Prime** plan (including Prime Remote or US Family Health Plan), you or a family member must notify your Primary Care Manager (PCM) or regional contractor (Humana Military in the East; TriWest in the West) within 24 hours or the next business day following an ER visit. This ensures your follow-up care is authorized and covered.

## Who this affects * **Active Duty Service Members:** Always $0, but must notify command/PCM. * **Active Duty Family Members:** Costs vary by Prime/Select status. * **Retirees and their Families:** Highest out-of-pocket costs, often tied to Group A/B status. * **National Guard and Reserve:** Beneficiaries on TRS or TRR. * **TRICARE For Life (TFL) Users:** Usually $0 after Medicare and TRICARE pay, provided the ER visit is a Medicare-covered service.

## Sources 1. **TRICARE.mil:** Emergency Room Care Overview (https://www.tricare.mil/CoveredServices/IsItCovered/EmergencyCare) 2. **TRICARE.mil:** 2026 Costs and Fees Sheet (https://www.tricare.mil/Costs) 3. **Humana Military (East Region):** Claims and Authorizations (https://www.humanamilitary.com) 4. **TriWest Healthcare Alliance (West Region):** Emergency Care Protocol (https://www.triwest.com)