Most health insurance including Medicare do not pay for caregivers, which is usually paid out of pocket by most families. IHSS of Santa Clara county pays around $15 per hr for around 200 hrs per month. Text 408-854-1883 for bay area caregivers from Motherhealth and for referrals to agencies , home health, non med and assisted living facilities.

Know Your 2024 TRICARE Health Plan Costs

By TRICARE Communications

FALLS CHURCH, Va.  –  With a new year fast approaching, you may see changes to your TRICARE health plan costs starting on Jan. 1, 2024. These costs may include enrollment fees, premiums, cost-shares, and copayments.

“TRICARE costs may change every year based on the law and the federal cost of living adjustment,” said Zelly Zim, a senior analyst with TRICARE Policy and Programs at the Defense Health Agency. “Other factors, which include changes in the costs of health care services and prescription drugs, can also affect TRICARE costs.”

Understanding the updated costs of your TRICARE health plan can help you prepare for TRICARE Open Season. This is the annual period when anyone enrolled in or eligible for TRICARE Prime, US Family Health Plan, or TRICARE Select can make changes to their health care coverage. This year’s open season starts on Nov. 13 and ends on Dec. 12. Changes you make during open season go into effect on Jan. 1, 2024.

Your beneficiary category and your beneficiary group determine your enrollment fees or premiums and out-of-pocket costs you may have with your TRICARE plan. TRICARE beneficiaries fall into one of two groups: Group A or Group B.

• You’re in Group A if your initial enlistment or appointment or that of your sponsor began before Jan. 1, 2018.
• You’re in Group B if your initial enlistment or appointment or that of your sponsor began on or after Jan. 1, 2018.

If you’re enrolled in a premium-based health plan, follow TRICARE Select Group B deductibles and applicable copayments and cost-shares. Premium-based health plans include these plans:

• TRICARE Reserve Select
• TRICARE Retired Reserve
• TRICARE Young Adult
• Continued Health Care Benefit Program

Below is a list of the 2024 costs for TRICARE health plans. Changes from 2023 costs are in bold.

Active Duty Family Member Costs

Active duty service members don’t have out-of-pocket costs. However, active duty family members (ADFMs) may have costs. These costs depend on your TRICARE health plan, your sponsor’s pay grade and group, the type of care you get, and where you get care. If you’re enrolled in a TRICARE Prime plan, you won’t have copayments unless you use the point-of-service option or fill a prescription outside of a military pharmacy.

Table 1 below shows your annual enrollment fee and annual deductible. Table 2 shows your annual catastrophic cap and network and non-network copayments and cost-shares. Changes from 2023 costs are in bold.

Table 1: Calendar Year 2024 TRICARE Select and TRICARE Prime Enrollment Fees and Deductibles: Active Duty Family Members

Out-of-pocket Cost		TRICARE Select		TRICARE Prime
		Group A	Group B	Group A	Group B
Annual enrollment fee	Individual	$0	$0	$0	$0
	Family	$0	$0	$0	$0
Annual deductible	Individual (E-4 and below)	$50	$62	$0	$0
	Family (E-4 and below)	$100	$125	$0	$0
	Individual (E-5 and above)	$150	$188	$0	$0
	Family (E-5 and above)	$300	$377	$0	$0

Table 2: Calendar Year 2024 TRICARE Select and TRICARE Prime Out-of-Pocket Costs: Active Duty Family Members

Out-of-pocket Cost	TRICARE Select		TRICARE Prime**
	Group A	Group B	Group A	Group B
Annual catastrophic cap	$1,000	$1,256	$1,000	$1,256
Preventive care visit	$0	$0	$0	$0
Primary care	Network: $27 Out-of-Network: 20%*	Network: $18 Out-of-Network: 20%*	$0	$0
Specialty care	Network: $38 Out-of-Network: 20%*	Network: $31 Out-of-Network: 20%*	$0	$0
Emergency room visit	Network: $104 Out-of-Network: 20%*	Network: $50 Out-of-Network: 20%*	$0	$0
Urgent care center visit	Network: $27 Out-of-Network: 20%*	Network: $25 Out-of-Network: 20%*	$0	$0
Ambulatory surgery	Network and Out-of-Network: $25	Network: $31  Out-of-Network: 20%*	$0	$0
Ambulance, outpatient ground	Network: $79 Out-of-Network: 20%*	Network: $18 Out-of-Network: 20%*	$0	$0
Ambulance, outpatient air	Network and Out-of-Network: 20%*	Network and Out-of-Network: 20%*	$0	$0
Durable medical equipment	Network: 15% Out-of-Network: 20%*	Network: 10% Out-of-Network: 20%*	$0	$0
Inpatient admission	Network and Out-of-Network: $22.30 per day; $25 minimum per admission	Network: $75 per admission Out-of-Network: 20%*	$0	$0
Inpatient skilled nursing facility/rehab facility	Network and Out-of-Network: $22.30 per day; $25 minimum per admission	Network: $31 per day Out-of-Network: $62 per day	$0	$0

*Percentage of TRICARE maximum-allowable charge after annual deductible is met.
**Out-of-network may result in using the point-of-service option.

Note: The costs for maternity (delivery and inpatient) are the same costs for inpatient admission. The costs for inpatient mental health are the same costs for inpatient admission. Mental health (primary care) follows the same costs as for primary care. Mental health (specialty care) follows the same costs as for specialty care.

Retired Service Members, Their Families, and Others

Table 3 below shows your TRICARE Select and TRICARE Prime annual enrollment fees and annual deductibles. Table 4 shows your TRICARE Select and TRICARE Prime catastrophic caps, network and non-network copayments, and cost-shares. Changes from 2023 costs are in bold.

Table 3: Calendar Year 2024 TRICARE Select and TRICARE Prime Enrollment Fees and Deductibles: Retired Service Members, Their Families, and Others

Out-of-pocket Cost		TRICARE Select		TRICARE Prime
		Group A	Group B	Group A	Group B
Annual enrollment fee	Individual	$177.96	$564.96	$363	$438.96
	Family	$355.92	$1,131	$726	$879
Annual deductible	Individual	$150	Network: $188 Out-of-Network: $377	$0	$0
	Family	$300	Network: $377  Out-of-Network: $754	$0	$0

Table 4: Calendar Year 2024 TRICARE Select and TRICARE Prime Out-of-Pocket Costs: Retirees, their Families, and all Others

Out-of-pocket cost		TRICARE Select		TRICARE Prime
		Group A	Group B	Group A	Group B
Annual catastrophic cap		$4,157	$4,399	$3,000	$4,399
Preventive care visit		$0	$0	$0	$0
Primary care		Network: $36 Out-of-Network: 25%*	Network: $31  Out-of-Network: 25%*	$25	$25
Specialty care		Network: $50 Out-of-Network: 25%*	Network: $50 Out-of-Network: 25%*	$37	$37
Emergency room visit		Network: $139 Out-of-Network: 25%*	Network: $100 Out-of-Network: 25%*	$75	$75
Urgent care center visit		Network: $36 Out-of-Network: 25%*	Network: $50 Out-of-Network: 25%*	$37	$37
Ambulatory surgery		Network: 20%* Out-of-Network: 25%*	Network: $119 Out-of-Network: 25%*	$75	$75
Ambulance, outpatient ground		Network: $106 Out-of-Network: 25%*	Network: $75 Out-of-Network: 25%*	$50	$50
Ambulance, outpatient air		Network and Out-of-Network: 25%*	Network and Out-of-Network: 25%*	$20	$20
Durable medical equipment		Network: 20%* Out-of-Network: 25%*	Network: 20%* Out-of-Network: 25%*	20%	20%
Inpatient admission	Network	$250/day up to 25% of hospital charges, plus 20% of separately billed services	$219 per admission	$188 per admission	$188 per admission
	Out-of-Network	ǂ$1,112/day up to 25% of hospital charges, plus 25% of separately billed services	25%*	$188 per admission	$188 per admission
Inpatient skilled nursing facility/rehab facility		Network: $250/day up to 25% of hospital charges, plus 20% of separately billed services; Out-of-Network: 25%*	Network: $62 per day Out-of-Network: $377 per day or 20%* (whichever is less)	$37 per day	$37 per day

*Percentage of TRICARE maximum-allowable charge after annual deductible is met.
ǂ This is the calendar year 2023 rate. The calendar year 2024 out of pocket expense will be available mid-December once the diagnosis-related group reimbursement payment rates are calculated.

Note: The calendar year catastrophic cap for TRICARE Select Group A retirees who are survivors of active duty deceased sponsors or medically retired Uniformed Service members and their dependents is $3,000.

Premium-Based Plans

When you or your family members purchase a premium-based health plan, you pay a monthly or quarterly premium.

Table 5 shows the monthly premiums for TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult Prime, and TRICARE Young Adult Select. Table 6 shows quarterly premiums for the Continued Health Care Benefit Program. Changes from 2023 costs are in bold.

Table 5: Calendar Year 2024 TRICARE Premium-Based Health Plans Monthly Premiums

Premium-based health plan	Member Only	Member and Family
TRICARE Reserve Select	$51.95	$256.87
TRICARE Retired Reserve	$585.24	$1,406.22
TRICARE Young Adult Prime	$637.00	Not applicable
TRICARE Young Adult Select	$311.00	Not applicable

Table 6: Calendar Year 2024 TRICARE Premium-Based Health Plans Quarterly Premiums

Premium-based health plan	Single	Family
Continued Health Care Benefit Program	$1,813.00	$4,539.00

Want to review your costs for the current year? Go to 2023 costs or the TRICARE Compare Costs tool. You can also go to Cost Terms to learn more about TRICARE out-of-pocket costs.

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