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Tricare Cost Co-Pay Schedule

An obstetrician confers with a female patient.

The following tables provide examples of cost shares or copayments and annual deductibles for families who use civilian providers and facilities under each of the Tricare options.

Tricare Categories

There are two separate categories of Tricare beneficiaries:

  • Group A for service members who entered active duty before 2018
  • Group B for service members who entered active duty in 2018 or later

Cost Shares and Deductibles for Active-Duty, Guard and Reserve Family Members:

Cost shares for retirees (under 65), their family members, and others:.

For more detailed information see our detailed Tricare program pages:

  • Tricare Prime
  • Tricare Select
  • Tricare Retired Reserve

Keep Up with Changes to Tricare and Your Other Benefits

Want to know about changes in military benefits as they happen? Subscribe to Military.com to get the latest benefits news delivered directly straight to your inbox.

Jim Absher, Military.com

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Health Net Federal Services

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  • TRICARE West
  • Beneficiary
  • Authorizations
  • Traveling Outside of the TRICARE West Region

Getting Care While Traveling

TRICARE beneficiaries can access medical care while traveling on business, vacation or when moving. However, all routine care should be obtained prior to travel, as this type of care may not be covered while away. 

Review the types of care below for additional coverage information. Visit TRICARE's Getting Care While Traveling page to learn more. 

Emergency Care

For emergencies while traveling away from home, beneficiaries should go directly to the nearest hospital emergency room. TRICARE Prime beneficiaries (or a family member on their behalf) should notify their primary care manager (PCM) within 24 hours of receiving emergency care to arrange for follow-up care. Learn more on our emergency care page.

Urgent Care

For treatment of urgent care conditions that cannot wait until returning home, please review TRICARE's urgent care guidelines on our urgent care page.

All TRICARE beneficiaries in the continental United States, Alaska and Hawaii can get health advice by contacting the Military Health System Nurse Advice Line, available 24 hours a day, 7 days a week. The Nurse Advice Line is staffed with registered nurses who provide professional medical advice to help TRICARE beneficiaries decide whether self-care is the best option, or they should see a health care provider. To access the Nurse Advice Line, visit MHSNurseAdviceLine.com or dial 1-800-TRICARE (1-800-874-2273) and choose option 1.

Visit www.tricare.mil for details.

Visit our Moving with TRICARE page to learn about the important steps to take to ensure a smooth transition to your new area. 

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TRICARE is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved.

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+1 469-383-7361

Lake Jackson ER 5 Minutes

Lumberton hospital 5 minutes, waxahachie er 5 minutes, first class emergency care for those who keep us safe., we’re safe, effective & always open., free medical screening, we welcome tricare – proud to serve our military personnel *not contracted with tricare, but do welcome it., altus emergency centers is proud to serve our military personnel.

The state of  Texas  is the proud host of more than 110,000 active duty military and 53,000 active reserves who have taken an oath to defend our country and the values for which it stands.

At Altus Emergency Centers we are honored to offer these brave service men, women and their families the highest standard of emergency medical care in times of need; it is our humble way of saying Thank You for all that you do.

Tricare® Emergency Coverage

An emergency can strike at any time and any place, in some instances getting to a military emergency room is not possible, for this reason, all Tricare® plans cover emergency care and all Altus Emergency Centers locations are available to treat military personnel and their family members at any time.

Tricare® coverage includes physician services as well as any supplies that are ordered or administered in the emergency room.

Which Tricare® Plans are Welcomed by Altus

Emergency medical care is part of the basic coverage in all Tricare® plans, this means that all active, reserve or retired members of Tricare® can receive treatment in any of Altus Emergency Centers locations.

Veteran and his family

All Tricare® plans cover emergency care and all Altus Emergency Centers locations are available to treat military personnel and their family members at any time.

What is considered an emergency by tricare®, there are different types of emergencies covered in all tricare® plans:.

These include accidental injuries as well as any sudden onset of a medical condition or the acute exacerbation of a chronic condition that:

  • Can be a threat to the patient’s life
  • Result in severe damage or loss of a limb or eyesight
  • Requires immediate medical attention
  • Produces severe painful symptoms that need medical treatment to alleviate suffering

Examples of medical emergencies include the following:

  • Patients with no pulse or who have lost consciousness
  • Injuries resulting in severe bleeding
  • Spinal cord or back injuries
  • Severe eye injury
  • A broken bone
  • Trouble or inability to breathe

Tricare® plans cover all sudden or unexpected medical complications which puts the lives of the mother or the baby at risk

Psychiatric

Prior authorization is not required for emergency room care when the patient represents an immediate danger to themselves or others as a result of a mental disorder.

What is the Cost of An Emergency Room Visit?

The cost of an emergency room visit will depend on the type of treatment received, however Altus Emergency Centers follows the pricing structure set by Tricare®.

This is the 2019 Cost Information for Emergency Room Visits provided by  Tricare®

Tricare® Prime and Tricare® Prime Remote (not including Tricare® Young Adult)

Tricare® select (not including tricare® young adult), tricare® reserve select (trs) and tricare® retired reserve (trr), tricare® young adult (tya).

For everyone working at  Altus Emergency Centers , it is both an honor and a privilege to be of assistance to our outstanding military personnel including those in active service, reserves or retirees. You deserve to receive the highest quality of emergency medical care in a time of crisis as well as our gratitude and respect for a job well done.

Our Promise is to Always Help Find the Best Solutions in Benefit of our Patients

We help make hassle-free billing possible..

Altus Emergency  is happy to offer special customer care billing management services through Patient Advocate.  This is our promise to you:

  • At Altus Emergency we have the ability to establish payment plans.
  • Within these payment plans, Altus Emergency has the ability to consider financial hardships.
  • Altus Emergency offers a special customer care service, Patient Advocate.  We will work with the insurance company for a complete payment.

If you have any questions regarding your billing, please contact our Patient Advocate Department.

Call us 469-383-7361 between 8:00 am and 5:00 pm and ask for the Patient Advocate.

Patient Advocate Resources – Articles, Insights, People & More Browse through our Patient Advocate Articles

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  5. TRICARE East Rehab Centers

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  6. Tricare East Patient Portal

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VIDEO

  1. February 2, 2024

COMMENTS

  1. Emergency Care

    TRICARE covers emergency care to include professional and institutional charges and services and supplies that are ordered or administered in an emergency department. Emergency care means care for an illness or injury that threatens your life, limb, sight, or safety. If you reasonably believe you have an emergency, always call 911 or your ...

  2. Emergency Care

    Call 911 or Go to the Emergency Room. Make sure you visit an emergency room. Urgent care clinics offer quick walk-in services without an appointment, but these facilities are not considered to be "emergency rooms." ... TRICARE East Region Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana ...

  3. PDF Tricare Prime Tricare Select

    Emergency Room Visit; $75. $75; Inpatient Admission (Hospitalization), Network; $188/ admission; $188/ admission; TRICARE Prime Point-of-Service Option. ... TRICARE East Region. Humana Military 1-800-444-5445 HumanaMilitary.com www.tricare-east.com. TRICARE Pharmacy Program. Express Scripts, Inc.

  4. PDF TRICARE Costs and ees 023

    Emergency Room Visit. $73: $73. Inpatient Admission (Hospitalization), Network. $182/ admission. $182/ admission. TRICARE Prime Point-of-Service Option. ... TRICARE East Region. Humana Military 1-800-444-5445 HumanaMilitary.com www.tricare-east.com. OOIN FOR. More nformation? O TO. www.tricare.mil.

  5. Referrals and Authorizations

    The Humana Military app makes it easier than ever to access claims, referrals and authorizations, payment options, in-network care and more. See what else there is to discover or download now to start exploring! TRICARE East beneficiaries can find information on referrals, authorizations and the Right of First Refusal (ROFR) process here.

  6. PDF Costs and Fees 2024

    Urgent Care Center Visit $37 $37 Emergency Room Visit $75 $75 Inpatient Admission (Hospitalization), Network $188/ admission $188/ admission . TRICARE Prime Point-of-Service Option . When you see a TRICARE-authorized provider other than your primary care manager for any nonemergency services without a referral, you pay:

  7. Find Care

    Search for TRICARE East providers, Primary Care Managers (PCM), military hospitals or clinics and more. If you are experiencing a medical emergency, call 911, or go to your nearest emergency room. If you receive care from a provider in a freestanding emergency room that is not affiliated to a hospital, TRICARE will not make reimbursement for ...

  8. TRICARE East

    For urgent referral and authorization submissions that can't be processed through self-service, please contact us at (800) 444-5445. For routine requests, please allow two-business-day waiting period to check if service is restored before resorting to fax. Please note, due to contractual obligations, Humana Military is unable to suspend audits ...

  9. Referrals and Pre-Authorizations

    Visit the Secure Patient Portal for more information. Service Point of Contact Information. Department of Defense SPOCs (Army, Air Force, ... TRICARE East Region-Humana Military. 1-800-444-5445. TRICARE East Region Website. TRICARE West Region Alaska, Arizona, California, Colorado, Hawaii, ...

  10. Emergency Room Costs

    2024 Cost Information for Emergency Room Visits. Note: Visit our Copayment and Cost-Share Information page to view 2023 costs. TRICARE ... and TRICARE Retired Reserve annual deductibles apply. TRICARE Young Adult costs are based on the sponsor's status. Transitional Assistance Management Program (TAMP) beneficiaries (service members and their ...

  11. Emergency Care

    Emergency Care. If you feel emergency care is needed, call 911 or go to the nearest military or civilian emergency room. An approval from Health Net Federal Services, LLC (HNFS) is not required for this care. Emergency conditions are those that threaten life, limb or eyesight. Emergency conditions include medical, maternity or psychiatric ...

  12. Filing Claims

    If you do, send your claim form to TRICARE as soon as possible after you get care. In the U.S. and U.S. territories, you must file your claims within one year of service. In all other overseas areas, you must file your claims within three years of service. There are many different types of claims you can file: Medical. Pharmacy.

  13. Emergency Care

    An emergency may also include the need for immediate help to treat severe pain or relieve suffering. Care that does not threaten life, limb or eyesight, but needs attention to prevent it from becoming a serious risk to health is known as urgent care. Visit our urgent care page to learn more. Note: Care for accidental injury to the teeth alone ...

  14. Get Familiar with Your Emergency and Urgent Care Options

    If you aren't clear whether your nonemergency injury or illness requires urgent care, you can contact the MHS Nurse Advice Line 24/7. Nurses can help you if you're uncertain about the care you need. They can also help direct people who may have COVID-19 to the appropriate care. If you're in the U.S., Guam, or Puerto Rico, call 1-800-874 ...

  15. TRICARE: Do You Need Emergency or Urgent Care?

    If you are unsure if you need urgent care, call the Nurse Advice Line (NAL) at 1-800-TRICARE (1-800-874-2273) and choose option 1. The NAL is available 24 hours a day, seven days a week. A registered nurse will confirm the level of care you need. Please note, the NAL is not for emergencies and is not a substitute for emergency treatment.

  16. Copayments & Cost-Shares

    Copayments & Cost-Shares. Costs are for calendar year (CY) 2024 unless noted separately. For TRICARE Prime Remote costs, choose "TRICARE Prime" from the pull-down menu. Visit the Cost Terms page for definitions to help you better understand TRICARE costs. If you're an unremarried former spouse, for the Continued Health Care Benefit Program ...

  17. Tricare Cost Co-Pay Schedule

    Group A: $139. Group B: $100. Hospital. $188/day. Group A: $250/day up to 25% of hospital charges, plus 20% of separately billed services. Group B: $219 per admission. For more detailed ...

  18. TRICARE East Beneficiaries

    The Humana Military app makes it easier than ever to access claims, referrals and authorizations, payment options, in-network care and more. See what else there is to discover or download now to start exploring! Humana Military, in partnership with TRICARE, is proud to serve beneficiaries in the East Region. Beneficiaries can find information ...

  19. Traveling Outside of the TRICARE West Region

    The Nurse Advice Line is staffed with registered nurses who provide professional medical advice to help TRICARE beneficiaries decide whether self-care is the best option, or they should see a health care provider. To access the Nurse Advice Line, visit MHSNurseAdviceLine.com or dial 1-800-TRICARE (1-800-874-2273) and choose option 1. Visit www ...

  20. Eisenhower Army Medical Center > Health Services

    Notify Humana Military within 24 hours at 1-800-444-5445 and notify your Primary Care Manager at 706-787-7300. Our commitment to you: When you or someone you love has an emergency, we are here for you. We know that little things can mean a lot. Our staff are not only skilled emergency professionals, but they are also understanding and ...

  21. Urgent & Emergency Care

    Urgent care is medically necessary care that you need for a sudden illness or injury that isn't life threatening. It does require immediate attention from a medical professional to avoid complications, like infection. Emergency care, on the other hand, is care you need to treat a serious medical condition immediately. This includes a mental ...

  22. TRICARE

    Tricare® coverage includes physician services as well as any supplies that are ordered or administered in the emergency room. Which Tricare® Plans are Welcomed by Altus Emergency medical care is part of the basic coverage in all Tricare® plans, this means that all active, reserve or retired members of Tricare® can receive treatment in any ...

  23. PDF TRICARE Costs and ees 023

    Emergency Room Visit. $73: $73. Inpatient Admission (Hospitalization), Network. $182/ admission. $182/ admission. TRICARE Prime Point-of-Service Option. ... TRICARE East Region. Humana Military 1-800-444-5445 HumanaMilitary.com www.tricare-east.com COSTS AND FEES 2023. LOOING FOR. More Information? GO TO.

  24. Naval Medical Center Portsmouth > Patient Resources > Health ...

    If there is an immediate threat to life, limb or eyesight; you are authorized to seek care from the nearest Emergency Room (ER). Following an ER visit, please schedule a follow up with your PCM to ensure your ER visit is properly authorized and that medical documentation is transferred back to the MTF. ... TRICARE East https://www ...