TRICARE Deductible: Definition and 2026 Rules | TRICARE.com

*Note: TRICARE.com is an independent reference site and is not affiliated with the official TRICARE program or the Department of Defense. For official policy, visit TRICARE.mil.*

## Definition A deductible is the specific fixed amount you must pay out-of-pocket for covered medical services each calendar year before TRICARE begins to pay for your healthcare costs.

## What it means in practice In the TRICARE system, your deductible is your "buy-in" for the year. Until you reach this amount, you are responsible for 100% of the TRICARE-allowable charge for most services. Once the deductible is met, you jump into the "cost-sharing" phase, where you only pay a percentage (coinsurance) or a flat fee (copayment) for visits, and TRICARE covers the rest.

Deductibles reset every January 1st and vary significantly based on your status and plan. For example, active duty service members (ADSMs) have $0 deductibles on all plans. However, for retirees and their families on TRICARE Select, the deductible is a major factor in annual costs. For 2026, a Group A retiree on TRICARE Select might see an individual deductible of $150 or a family deductible of $300. In contrast, TRICARE Prime usually has no deductible for network care, unless you use the Point-of-Service (POS) option.

It is important to distinguish between "Individual" and "Family" deductibles. If you have a family plan, you do not necessarily need every person to hit their individual limit. Once the family-wide total reaches the "Family" deductible cap, the deductible is considered met for everyone on the plan for the remainder of the calendar year.

Note that the deductible is separate from your "Catastrophic Cap." While the deductible is what you pay to *start* your benefits, the Catastrophic Cap is the *maximum* you will ever pay in a year. Once you hit that cap (which includes your deductible payments), TRICARE pays 100% for all covered services.

## Related terms * **Catastrophic Cap:** The maximum out-of-pocket amount you will pay for covered services per calendar year. * **Cost-Share:** The percentage of the total TRICARE-allowable amount you pay after your deductible is met (usually associated with TRICARE Select). * **Copayment:** A fixed dollar amount you pay for a specific medical service or prescription once your deductible is met. * **TRICARE-Allowable Charge:** The maximum amount TRICARE will pay for a specific procedure or service, which limits what providers can charge you. * **Point-of-Service (POS) Option:** An additional cost-sharing penalty (including a separate deductible) for TRICARE Prime members who seek care from a non-network provider without a referral.

## Sources * TRICARE.mil: [Costs and Fees](https://www.tricare.mil/costs) * Defense Health Agency: [TRICARE Select Costs](https://www.tricare.mil/Plans/HealthPlans/TS) * TriWest Healthcare Alliance (West Region): [Claims and Costs](https://www.triwest.com)