Payment requirements for TRICARE beneficiaries

October 21, 2022

When receiving care under your TRICARE benefit, it’s important to know the requirements around costs.

Providers have a duty to seek applicable cost-shares or deductibles, but a provider cannot charge beneficiaries more than their cost-share or deductible.

TRICARE network providers and participating non-network providers who are TRICARE-certified agree to accept the TRICARE-allowable charge as payment in full for a covered service.

Non-network providers who are not TRICARE-certified may bill TRICARE beneficiaries up to 15 percent above the TRICARE-allowable charge.

A refund of any amount over the TRICARE beneficiary’s cost-share/deductible must be provided to the beneficiary in a timely manner.

To get more information about payments at your next provider’s visit, see TRICARE Costs