Military Health, Tricare programs - Army Times

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Tricare Standard



Standard is modeled after a traditional fee-for-service health plan. Authorized doctors, hospitals and other providers are paid a specific amount for each service performed. Individuals may choose doctors, but they pay more than under other Tricare plans. Certain procedures also require pre-authorization. For civilian doctor visits, co-payments are a percentage of the allowable charge. Retirees pay 25 percent; other eligible beneficiaries pay 20 percent.

Standard patients must meet outpatient deductibles before their insurance benefits begin. Deductibles, which depend on rank and family status, range from $50 to $150 for an individual and $100 to $300 for a family. The annual catastrophic cap on allowable charges for covered services is $1,000 for active-duty families and $3,000 for retirees.

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