TRICARE Prime | Active-Duty Family Member (Individual/Family) | Retired (Individual/Family) |
Annual Enrollment | $0 | $350 / $700 |
Annual deductible | No | No |
Annual catastrophic cap | $1,000 | $3,500 |
Outpatient visit civilian network | $0 | $20 primary care |
$30 specialty care | ||
ER visit civilian network | $0 | $60 network |
Urgent care civilian network | $0 | $30 network |
Ambulatory surgery civilian network | $0 | $60 network |
Ground ambulance civilian network | $0 | $40 |
Durable medical equipment civilian network | $0 | 20% of negotiated fee, network |
Inpatient visit civilian network | $0 | $150 per admission |
Inpatient skilled nursing/rehab civilian | $0 | $30 per day network |
10 U.S.C. § 1075a
EDITORIAL NOTES
REFERENCES IN TEXTThe date of the enactment of the National Defense Authorization Act for Fiscal Year 2024, referred to in subsec. (a)(4)(B), is the date of enactment of Pub. L. 118-31, which was approved Dec. 22, 2023.
AMENDMENTS2023-Subsec. (a)(4). Pub. L. 118-31 added par. (4).2017-Subsec. (b)(1). Pub. L. 115-91, §739(b)(2)(B), which directed amendment of "Paragraph (1) of such section" by substituting "Ground ambulance civilian network" for "Ambulance civilian network" in first column of table, was executed by making the substitution in par. (1) of subsec. (b) of this section, to reflect the probable intent of Congress.Subsec. (b)(4). Pub. L. 115-91, §739(b)(2)(A), added par. (4).Subsec. (c). Pub. L. 115-91, §739(e)(2), substituted "section 1095f(a)" for "section 1075f(a)".
STATUTORY NOTES AND RELATED SUBSIDIARIES
EFFECTIVE DATESection applicable with respect to the provision of health care under the TRICARE program beginning on Jan. 1, 2018, see section 701(k) of Pub. L. 114-328, set out as an Effective Date of 2016 Amendment note under section 1072 of this title.
- TRICARE Prime
- The term "TRICARE Prime" means the managed care option of the TRICARE program.
- TRICARE program
- The term "TRICARE program" means the various programs carried out by the Secretary of Defense under this chapter and any other provision of law providing for the furnishing of medical and dental care and health benefits to members and former members of the uniformed services and their dependents, including the following health plan options:(A) TRICARE Prime.(B) TRICARE Select.(C) TRICARE for Life.
- health care
- The term "health care" includes mental health care.
- pay
- The term "pay" includes basic pay, special pay, retainer pay, incentive pay, retired pay, and equivalent pay, but does not include allowances.
- uniformed services
- The term "uniformed services" means-(A) the armed forces;(B) the commissioned corps of the National Oceanic and Atmospheric Administration; and(C) the commissioned corps of the Public Health Service.