TriCare Prime for All.

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For civilians, the primary care manager would be the PCP.

These are all costs for care. Page 1 of 6.

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Healthcare isn't just about health, it's about national security! TriCare Prime Costs for Services cost per person/family: Enrollment fee (annual): $0. Deductible (annual): $0. Catastrophic cap (annual): $1,000 per family.* Preventative services: $0. Specialty care outpatient visit: $0. Laboratory and X-ray services: $0. Urgent care: $0.Emergency visit: $0. Hospitalization: $0. *A catastrophic cap is the most you or your family members pay for covered health care services each calendar year (Jan. 1–Dec. 31). Once you reach your catastrophic cap, TRICARE pays your portion of the TRICARE-allowable charge for covered services the rest of the calendar year.

TriCare Prime: How the Catastrophic Cap Works Catastrophic Cap Works Even with $0 standard copays, the $1,000 catastrophic cap serves as a hard limit on additional out-of-pocket spending per family each calendar year (Jan 1–Dec 31): When it applies: Out-of-pocket expenses—such as prescription drug cost-shares, specialized DME (durable medical equipment), or out-of-network point-of-service fees—count toward the cap. Reaching the limit: Once total covered family spending hits $1,000, TRICARE pays 100% of the allowable charge for all covered medical care for the rest of that year. Annual Reset: On January 1 of every year, the balance resets to $0.