What is Co-Managed Care for Veterans?

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TRICARE Prime (Out-of-pocket) Costs

TRICARE Prime is the best of the TRICARE health plans available. There is no annual deductible or enrollment fee for active duty personnel and their dependents. You choose a Primary Care Manager (PCM) and incur no costs if you use military health installations or civilian TRICARE authorized providers. However, if you choose to get non-emergency care from a TRICARE provider for point-of-service (POS) care without a referral from your PCM, you will have to pay 50% of the costs after a small deductible is met.

Keep in mind that for retirees and their family members, there is an annual enrollment fee of $230 per individual or $460 per family. But there is no annual deductible as there is with TRICARE Standard or Extra. As far as out of pocket costs go there are some things you will have to pay for. If you have civilian outpatient visits they will cost $12, and emergency care visit will run you $30. The civilian impatient fee is $11 per day with a $25 minimum charge. Any behavioral health costs will be $40 a day. Your usage history can help you determine if TRICARE Prime is a good choice for you.

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