They can also get care at VA medical facilities with a referral/pre-authorization. They can get medical care from any military hospital or clinic, but there are limitations and/or pre-authorizations required for non-urgent care. Retiring servicemembers remain enrolled in TRICARE Prime at their last duty station until the date of retirement. Dependents’ coverage is the same they have copays for commercial pharmacy and Express Scripts and free prescriptions through the MTF system. ![]() Military retirees now have a copay when filling prescriptions via commercial pharmacies or home delivery through Express Scripts. Group B:Those entering on or after Jan.Group A:All servicemembers and their families who entered service prior to Jan.Group designations determine which fee structure for enrollment, deductible, copay, and catastrophic cap each beneficiary must pay. TRICARE Prime and Select enrollment fees count against the CC. The CC increases in retirement from $1,000 to $3,000 for Prime and $3,500 for Select. The CC is reset every calendar year, and the amount amassed on active duty during a retirement year rolls into the retirement CC. The catastrophic cap (CC) is the most you will pay out of pocket for covered services each year before TRICARE picks up all additional covered costs. ![]() Your retirement from active duty also allows you to change TRICARE coverage if desired. These events include a move, birth of a child, marriage, divorce, and death. QLEs allow you to make changes to your TRICARE benefits outside of the open season. Spouses may sign up for different plans, and they will be charged at the individual rate for their plan versus the family rate. For individuals, the first $150 in medical charges must be picked up by the retiree. ![]() TRICARE Select’s annual deductible is $300 for families. Also, enrollment fees now count against the catastrophic cap, as do deductibles. TRICARE Select began charging an enrollment fee for military retirees in 2021: $150 for individuals and $300 for families per year. TRICARE Select is the most flexible TRICARE program, though you will need to find medical care providers who accept TRICARE, and copays are higher than TRICARE Prime copays. After the deductible is reached, you can expect co-pays that are typically 50% of the allowable TRICARE fee. You will incur a deductible ($300 individual/$600 family) that will not apply to your catastrophic cap. Try to find a specialist who accepts TRICARE to reduce costs. Under TRICARE Prime, you will incur point-of-service charges for any specialty care you receive without a referral. This option is more expensive than enrollment at an MTF, with copays for medical services. TRICARE contracts with medical providers to offer a civilian care Prime option in many metro areas. If one MTF isn’t available, the contractor will tell you if another MTF in your area is accepting new retirees and families.Ĭheck on your preferred MTF at the next open season or qualifying life event (QLE). Each MTF has a limit on retirees and families they can accept.
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