Proposed TRICARE Fee Changes

Military.com

Published February 18, 2012

This information is being updated, pleaes visit our TRICARE home page for more TRICARE information.Proposed Changes to TRICARE Fees

The following tables reflect the proposed changes to TRICARE fees, deductibles, and co-pays for Fiscal Year 2013 through 2017. The enrollment fees and deductible changes would affect military retirees only. The changes to TRICARE Pharmacy co-pays would affect all TRICARE beneficiaries.

Proposed TRICARE Prime Annual Family Enrollment Fees (Individual Fees are 50%) for Working-Age Retirees

Retired Pay Tiers	FY 2012	FY 2013	FY 2014	FY 2015	FY 2016*	FY 2017
Tier 1: $0 – $22,589	$460/$520	$600	$680	$760	$850	$893
Tier 2: $22,590 – $45,178	$460/$520	$720	$920	$1,185	$1,450	$1,523
Tier 3: Over $45,178	$460/$520	$820	$1,120	$1,535	$1,950	$2,048

*Indexed to medical inflation (National Health Expenditures) after FY 2016.

Proposed TRICARE Standard/Extra Fees/Deductibles for Working-Age Retirees

Annual Enrollment Fees	FY 2012	FY 2013	FY 2014	FY 2015	FY 2016	FY 2017*
Individual	$0	$70	$85	$100	$115	$130
Family	$0	$140	$170	$200	$230	$250

Annual Deductibles
Individual	$150	$160	$200	$230	$260	$290
Family	$300	$320	$400	$460	$520	$580

*Indexed to medical inflation (National Health Expenditures) after FY 2017.

Proposed TRICARE-for-Life (TFL) Annual Enrollment Fees – Per Individual

Retired Pay Tiers	FY 2012	FY 2013	FY 2014	FY 2015	FY 2016*	FY 2017
Tier 1: $0 – $22,589	$0	$35	$75	$115	$150	$158
Tier 2: $22,590 – $45,178	$0	$75	$150	$225	$300	$317
Tier 3: Over $45,178	$0	$115	$225	$335	$450	$475

*Indexed to medical inflation (National Health Expenditures) after FY 2016.

Proposed Pharmacy Co-Pays for All TRICARE Beneficiaries

RX Source	FY 2012	FY 2013	FY 2014	FY 2015	FY 2016	FY 2017
Retail – 1 month fill
Generic	$5	$5	$6	$7	$8	$9
Brand Name	$12	$26	$28	$30	$32	$34
Non-Formulary*	$25	N/A	N/A	N/A	N/A	N/A

Mail-Order – 3 month fill
Generic	$0	$0	$0	$0	$0	$9
Brand	$9	$26	$28	$30	$32	$34
Non-Formulary	$25	$51	$54	$58	$62	$66

Military Treatment Facilities	No Change – Remains $0 Co-Pay

* Non-Formulary pharmaceuticals will have limited availability in retail pharmacies

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