Tricare Prime Coverage Details

Tricare Prime is a health insurance program offered to active-duty members, retirees, activated Guard and reserve members, and families. If you're on active duty, you have to enroll in Tricare Prime. All others can choose to enroll in Tricare Select. Tricare Prime offers fewer out-of-pocket costs than Tricare Select, but less freedom to choose providers.

There are four Tricare Prime Plans:

1. Tricare Prime
2. Tricare Prime Remote
3. Tricare Prime Overseas
4. Tricare Prime Remote Overseas

Each plan is generally the same, differing only in the geographical area that it covers.

Tricare Groups

The two groups of Tricare beneficiaries include:

1. Group A: The service member entered active duty before 2018.
2. Group B: The service member entered active duty in 2018 or later.

Tricare Prime for Families of Active-Duty Members

Family members of active-duty personnel will pay:

• Minimal out-of-pocket costs
• No enrollment fees
• No network copayments
• No point-of-service fees unless using the point-of-service option

Tricare Prime for Families of Retirees

Retirees using Tricare Prime will pay an annual enrollment fee in 2024 of $363 for a single member and $726 for a family for those in Group A; and $438.96 for a single member and $879 for a family for those in Group B.

Catastrophic Cap

The catastrophic cap is the maximum amount you will pay out of pocket annually for all health care. The catastrophic cap resets each year.

Active-duty beneficiaries in Group A have a catastrophic cap of $1,000 in 2024, and Group B's is $1,256. Retired beneficiaries have a catastrophic cap of $3,000 for Group A or $4,399 for Group B.

Copay Amounts

In addition to an enrollment fee, you also may pay a copayment for various services received at network providers. These fees are:

2024 Tricare Prime Copayments

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Amanda Miller

Amanda Miller is an editor and writer for Military.com specializing in coverage of military and veteran pay and benefits. She became a journalist in the 1990s, began covering the military in 2007 for Military Times, and has since contributed to a number of military-oriented publications including Military Officer Magazine, The War Horse, and Air & Space Forces Magazine. Read Full Bio

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