Update your TRICARE eligibility status. To update eligibility status for a family member, contact the Defense Enrollment Eligibility Reporting System (DEERS) at (800) 538-9552 and verify what documentation is required for the change. It is the responsibility of the TRICARE beneficiary, parent or legal representative to report a change in status. TRICARE Reserve Select $47.20 $238.99 TRICARE Retired Reserve $484.83 $1,165.01 TRICARE Young Adult Prime $459 Not available TRICARE Young Adult Select $257 Not available When enrolled in a premium-based health plan (TRS, TRR, TYA Prime, TYA Select, or CHCBP), you pay a monthly or quarterly premium and follow Group B deductibles and applicable. Premiums paid under TRICARE Reserve Select, TRICARE Retired Reserve and TRICARE Young Adult. 2021 Catastrophic Cap Amounts. 2021 Group A Group B; Active Duty Family Members (TRICARE Prime and Select) $1,000 per family, per calendar year: $1,058 per family, per calendar year. For TRICARE Select benefits, you will pay a cost share or copayment at the time that you receive any medical services. This TRICARE Select copay will vary and will increase if you use a provider who is not in the network of authorized providers according to TRICARE.
- Tricare Reserve Select Prescription Copay
- Tricare Reserve Select 2021 Costs
- Tricare Reserve Select Premium 2021
- Tricare Reserve Select Rate Per Month
Many costs will be relatively stable in the coming year for military families in Tricare, and pharmacy costs won’t increase, according to new fee information from the Defense Health Agency’s Tricare website.
The notable exceptions are enrollment fees for Tricare Retired Reserve, Tricare Young Adult, and retirees in Tricare Select Group A. As previously reported, monthly enrollment fees are rising sharply for those in Tricare Young Adult, and retirees in Tricare Select Group A must start paying an enrollment fee in 2021.
Active duty families in Tricare Select will see increases of up to a few dollars in the cost-shares they pay for health care for certain services in 2021.
Across the board, pharmacy costs won’t change for all beneficiaries.
Some costs related to non-network inpatient hospitalization care haven’t yet been determined, and are expected to be released in December.
Active duty families in Tricare Prime only pay for care when they get care without a referral, or use non-network providers without authorization, or use a pharmacy other than a military pharmacy. There are no charges to active duty members for any type of health care.
There are differences in some costs for populations based on when the sponsor entered the military. Those who entered before Jan. 1, 2018, are considered Group A. Those who entered on or after Jan. 1, 2018, are considered Group B. It’s based on the Fiscal 2017 National Defense Authorization Act, which implemented Tricare reform. The law required that retirees in Group A start paying the enrollment fee, but delayed it until 2021. This doesn’t apply to those in the Tricare for Life plan.
By law, DoD is required to raise certain beneficiary out-of-pocket cost shares by an amount based on the annual cost of living adjustment, or COLA, for retirees. The COLA is 1.3 percent for 2021.
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There are about 4.9 million DoD beneficiaries enrolled in Tricare Prime plans, and about 2.1 million enrolled in Tricare Select plans.
Some examples of changes, based on information pulled from the Tricare website’s cost comparison tool, which can also be used for research for the upcoming enrollment open season, from Nov. 9 to Dec. 14:
Enrollment fees: Those in the Tricare Young Adult program will pay $459 per month for Prime, an increase of 22 percent; or $257 for Select, an increase of 12 percent.
• “Gray area” retirees using Tricare Retired Reserve will see enrollment fee increases by about $40 a month for individuals, to $484.83 a month; and by about $99 for families, to $1,165.01 a month. That’s an increase of nearly $1,200 a year for families. There are currently about 3,858 gray area reservist retirees under age 60 with Tricare Retired Reserve plans that cover about 10,400 people. Premiums for Tricare Young Adult, Tricare Retired Reserve and Tricare Reserve Select are set based on analyses of the actual costs in the previous year.
• In addition, the previously reported new Tricare Select fee for retirees in Group A goes from 0 to $150 a year for individuals and $300 for families.
Tricare Reserve Select Prescription Copay
• Of most other Tricare plans with enrollment fees, increases ranged from $3 to $10, depending on the plan. There are no enrollment fees for active duty families in Prime or Select.
Deductibles: These costs stay the same, or increase by amounts ranging from $1 to $8, depending on the plan. There is no deductible for active duty families in Prime.
Catastrophic cap: The catastrophic cap is the most amount of money you pay out of pocket each year for services covered by Tricare, before Tricare will start picking up 100 percent of the cost. It’s increasing for beneficiaries in most Prime and Select programs, except for Tricare for Life, where it remains at $3,000; active duty families in Prime and Select who are in Group A, where it remains at $1,000; and retirees in Tricare Prime, Group A, where it remains at $3,000.
The biggest increase in catastrophic cap is for retirees in Tricare Select, Group A, where it increases from $3,000 to $3,500. That means these retirees will now pay an extra $500 out of pocket before Tricare will start picking up 100 percent of the cost.
Tricare Reserve Select 2021 Costs
Family members of active-duty sponsors who entered the military after Jan. 1, 2018, will see their catastrophic cap increase by $14, from $1,044 to $1,058, whether they are in Prime or Select, as do those in several other Tricare plans.
Primary care visits: Most costs stay the same, except for retirees in Prime, both Group A and B, with an increase of $1 (to $21) for in-network visits.
Urgent care: Where there are changes, the increases are by $1.
Tricare Reserve Select Premium 2021
Mental health outpatient/partial hospitalization: Most costs stay the same, except for $1 increases in some plans.
Emergency care: Where there are changes, the increases range from $1 to $7.
Pharmacy costs are staying the same through 2021 for all beneficiaries:
• Generic (Tier 1) drugs are at no cost at a military pharmacy; for home delivery they are $10; at a network retail pharmacy they are $13.
Tricare Reserve Select Rate Per Month
• Brand-name (Tier 2) drugs are at no cost at a military pharmacy; for home delivery they are $29; at a network retail pharmacy they are $33.
Again, these are but a few examples; more information is available at the Tricare cost comparison tool.