Tricare Urgent Care Copay

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Coronavirus (COVID-19) Update:

  • Testing copayment waiver: Retroactive to March 18, 2020, TRICARE will waive copayments/cost-shares for medically necessary COVID-19 diagnostic and antibody testing and related services, and office visits, urgent care or emergency room visits during which tests are ordered or administered. COVID-19 diagnostic and antibody tests must meet Families First Coronavirus Response Act (FFCRA) criteria in order to be eligible for the cost-share and copayment waivers.
  • Telemedicine copayment waiver: TRICARE is waiving copayments and cost-shares for covered audio-only or audio/video telemedicine rendered by network providers on or after May 12, 2020. This waiver applies to covered in-network telehealth services, not just services related to COVID-19. Beneficiaries who seek telehealth from non-network providers are liable for their regular copayment or cost-share. TRICARE Prime beneficiaries who seek care from specialists without an approved referral when required are subject to Point of Service fees.

Providers are expected to refund cost-sharing amounts to beneficiaries as appropriate.

  • TRICARE Prime beneficiaries who seek care from specialists without an approved referral when required are subject to Point of Service fees. In response to the COVID-19 pandemic, the Defense Health Agency (DHA) is temporarily expanding telemedicine for specific benefits.
  • Urgent care copay rates (Care for minor illnesses and injuries) There's no limit to how many times you can use urgent care. To be eligible for urgent care benefits, including through our network of approved community providers, you must. Be enrolled in the VA health care system, and Have received care from us within the past 24 months (2 years).
  • Primary and Urgent Care, and Telehealth All plans Richmond: All covered services are in network Hampton Roads: HMO services are out of network. Tricare (Network Provider) Primary and Urgent Care, and Telehealth UnitedHealthcare. Primary and Urgent Care, and Telehealth MAMSI Life & Health MDIPA: Not available in Tidewater.
  • Note: Visit our Copayment and Cost-Share Information page for 2021 costs. View the cost information below for TRICARE Reserve Select (TRS) beneficiaries. The sponsor's enlistment date does not determine costs. TRS members are covered under TRICARE Select.

Tricare Select Urgent Care

Prime

Patients who use TRICARE Prime, or any other TRICARE plan, may visit any TRICARE-authorized network UCC for urgent care. Active duty personnel are not authorized urgent care clinic visits without a referral. Patients may find more convenience, shorter wait.

Note: Visit our Copayment and Cost-Share Information page to view 2020 costs.
  • TRICARE Select, TRICARE Young Adult Select, TRICARE Reserve Select, and TRICARE Retired Reserve annual deductibles apply.
  • TRICARE Young Adult costs are based on the sponsor's status.
  • TRICARE Prime and TRICARE Young Adult Prime retirees have a separate copayment for allergy shots performed on a different day than the office visit, or performed by a different provider, such as an independent laboratory or radiology facility (even if performed on the same day as the related office visit).
  • Transitional Assistance Management Program (TAMP) beneficiaries (service members and their family members) follow the active duty family member copayment/cost-share information, based on the TRICARE plan type.

Tricare Urgent Care List

A beneficiary's cost is determined by the sponsor's initial enlistment or appointment date:

  • Group A: Sponsor's enlistment or appointment date occurred prior to Jan. 1, 2018.
  • Group B: Sponsor's enlistment or appointment date occurred on or after Jan. 1, 2018.
Care

TRICARE Prime and TRICARE Prime Remote (not including TRICARE Young Adult)

Tricare West Urgent Care Copay

ServiceActive Duty Family MembersRetirees and Their Family Members
Primary Care Outpatient
Office Visits

Group A: $0

Group B: $0

Group A: $21

Group B: $21

Specialty Care Outpatient
Office Visits

(this includes physical, occupational
and speech therapy, and provisional coverage benefits)

Group A: $0

Group B: $0

Group A: $31

Group B: $31

TRICARE Select (not including TRICARE Young Adult)

ServiceActive Duty Family MembersRetirees and Their Family Members
Primary Care Outpatient
Office Visits

Group A:

Network Provider: $22
Non-Network Provider: 20%

Group B:

Network Provider: $15
Non-Network Provider: 20%

Group A:

Network Provider: $30
Non-Network Provider: 25%

Group B:

Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient
Office Visits

(this includes physical, occupational
and speech therapy, and provisional coverage benefits)

Group A:

Network Provider: $34
Non-Network Provider: 20%

Group B:

Network Provider: $26
Non-Network Provider: 20%

Group A:

Network Provider: $46
Non-Network Provider: 25%

Group B:

Network Provider: $42
Non-Network Provider: 25%

Copay

TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)

Tricare

Tricare Urgent Care Copay 2020

ServiceTRSTRR
Primary Care Outpatient
Office Visits		Network Provider: $15
Non-Network Provider: 20%		Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient
Office Visits

(this includes physical, occupational
and speech therapy, and provisional
coverage benefits)

Network Provider: $26
Non-Network Provider: 20%		Network Provider: $42
Non-Network Provider: 25%

TRICARE Young Adult (TYA)

Tricare East Urgent Care Copay

ServiceTYA PrimeTYA Select
Active Duty Family MembersRetiree Family MembersActive Duty Family MembersRetiree Family Members
Primary Care Outpatient Office Visits$0$21Network Provider: $15
Non-Network Provider: 20%		Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient Office Visits

(this includes physical,
occupational and speech therapy, and provisional coverage benefits)

$0$31Network Provider: $26
Non-Network Provider: 20%		Network Provider: $42
Non-Network Provider: 25%