| Beneficiaries | TRICARE Prime | TRICARE Extra | TRICARE Standard |
|---|---|---|---|
| Active Duty Personnel | automatic, free enrollment; free care | n/a | n/a |
| POS option | annual deductible of $300 per individual, or $600 per family; after deductible paid, POS cost-share of 50% of TRICARE allowable charge; may pay additional charges (up to 15% above allowable charge) for non-network providers | n/a | n/a |
| Beneficiaries | TRICARE Prime | TRICARE Extra | TRICARE Standard |
| Spouse and children of Active Duty Personnel | must complete enrollment form; no enrollment fee | no enrollment fee; military ID card for services (DEERS) | no enrollment fee; military ID card for services (DEERS) |
| deductible | none | E-4 and below: $50 per person, $100 per family E-5 and above: | E-4 and below: $50 per person, $100 per family E-5 and above: |
| copayment | none | 15% of cost for civilian outpatient visit; $11.45 per day for civilian inpatient admission; $11.45 per day or $25 minimum, which ever is greater, for civilian inpatient mental health | 20% of cost for civilian outpatient visit; $11.45 per day for civilian inpatient admission; $11.45 per day or $25 minimum, which ever is greater, for civilian inpatient mental health |
| maximum annual cost | ? | $1000 | $1000 |
| Beneficiaries | TRICARE Prime | TRICARE Extra | TRICARE Standard |
| Retirees and their family members; includes unremarried spouse and children of active duty or retired | Annual enrollment fee: $230 per person or $460 per family | no enrollment fee; military ID card for services (DEERS) | no enrollment fee; military ID card for services (DEERS) |
| deductible | none | $150 per person, $300 per family | $150 per person, $300 per family |
| copayment | $12 per civilian outpatient visit; $30 per civilian emergency care; $25 per civilian mental health visit | 20% of negotiated fee for civilian outpatient visit, or emergency care visit, or mental health visit | 25% of allowable charges for civilian outpatient visit, or emergency care visit, or mental health visit |
| Civilian Inpatient Cost Share | $11 per day ($25 minimum) | Lesser of $401 per day or 25% of hospital billed charges; plus 20% professional fees | Lesser of $401 per day or 25% of hospital billed charges; plus 25% professional fees |
| Civilian Inpatient Mental Health | $40 per day | 20% of institutional charge plus 20% professional fee | Lesser of $149 per day or 25% of institutional fee plus 25% professional charges |
| maximum annual cost | $3000 | $7500 | $7500 |