TRICARE Costs 2025: Premiums, Copays and What You’ll Actually Pay

Understanding TRICARE Plans and Costs

TRICARE provides health coverage for military members, retirees, and their families. Knowing the costs for each plan helps you choose the right coverage and budget for healthcare expenses. Here’s a comprehensive breakdown of 2025 TRICARE costs across all major plan options.

TRICARE Prime Costs

TRICARE Prime is a managed care option with assigned primary care managers and the lowest out-of-pocket costs. Active duty members pay nothing for TRICARE Prime.

2025 TRICARE Prime enrollment fees (retirees and families):

• Individual: $185.88/year ($15.49/month)
• Family: $371.64/year ($30.97/month)

TRICARE Prime copays:

• Primary care visit: $0
• Specialty care visit: $0 with referral
• Emergency room: $75 (waived if admitted)
• Urgent care: $30
• Inpatient admission: $0
• Mental health outpatient: $0

TRICARE Prime provides the most predictable costs but requires using network providers and obtaining referrals for specialty care.

TRICARE Select Premiums and Deductibles

TRICARE Select offers more flexibility in choosing providers without referrals but has higher out-of-pocket costs. Active duty family members have no enrollment fees but do have cost-shares.

2025 TRICARE Select enrollment fees (retirees and families):

• Individual: $187.32/year ($15.61/month)
• Family: $374.52/year ($31.21/month)

Annual deductibles (Group A – active duty families):

• Individual: $50
• Family: $100

Annual deductibles (Group B – retirees and families):

• Individual: $150
• Family: $300

Cost-shares after deductible (retirees):

• Primary care (network): $25
• Specialty care (network): $35
• Emergency room: $90
• Urgent care: $35
• Inpatient admission: $175/day (up to $350 per admission)

TRICARE For Life (Medicare Supplement)

TRICARE For Life (TFL) provides secondary coverage for military retirees and their families who have Medicare Part A and Part B. TFL has no enrollment fee, but you must pay Medicare Part B premiums.

2025 costs:

• TFL enrollment fee: $0
• Medicare Part B premium: $185.00/month (standard; higher for high-income beneficiaries)
• TFL deductible: None beyond Medicare deductibles
• TFL cost-share: $0 for Medicare-covered services

TFL pays remaining costs after Medicare, typically resulting in zero out-of-pocket for most covered services. It’s one of the best supplemental coverage options available.

Pharmacy Copays

TRICARE pharmacy costs depend on where you fill prescriptions and the drug tier:

Military pharmacy (MTF):

• All medications: $0

TRICARE Pharmacy Home Delivery (90-day supply):

• Generic: $12
• Brand-name formulary: $34
• Non-formulary: $68

Retail pharmacy (30-day supply):

• Generic: $14
• Brand-name formulary: $38
• Non-formulary: $68

Tip: Using military pharmacies or home delivery saves significant money, especially for ongoing medications. A brand-name medication costing $38/month retail would cost $0 at an MTF or about $11.33/month through home delivery.

Out-of-Pocket Maximums

TRICARE limits your annual out-of-pocket expenses through catastrophic caps:

2025 catastrophic caps:

• Active duty families: $1,000/year
• Retiree families (Prime): $4,500/year
• Retiree families (Select): $4,500/year
• Reserve/Guard families: $1,000/year

Once you reach the catastrophic cap, TRICARE pays all additional covered expenses for the remainder of the fiscal year (October 1 – September 30).

Comparing TRICARE Plans

Choose TRICARE Prime if you:

• Want the lowest out-of-pocket costs
• Don’t mind getting referrals for specialty care
• Live near military treatment facilities or Prime network providers
• Have ongoing health conditions requiring frequent care

Choose TRICARE Select if you:

• Want freedom to see any TRICARE-authorized provider
• Prefer not to need referrals for specialists
• Are generally healthy and don’t anticipate high medical costs
• Travel frequently or live in remote areas

Tips for Minimizing TRICARE Costs

• Use military pharmacies: Fill prescriptions at MTFs for zero cost
• Choose home delivery: Save on copays for maintenance medications
• Stay in network: Network providers accept TRICARE rates, preventing balance billing
• Use preventive care: Annual physicals and screenings are fully covered
• Consider Prime: If you anticipate significant healthcare needs, Prime’s lower cost-shares often result in overall savings
• Track your deductibles: Once met, your cost-shares decrease for the year
• Verify provider authorization: Ensure providers are TRICARE-authorized before appointments

For detailed information or assistance choosing a plan, contact TRICARE at 1-800-444-5445 or visit the TRICARE website.