Tricare Standard - Marine Corps Health Issues | Marine Corps Times

Tricare Standard

Standard is modeled after a traditional fee-for-service health plan. Authorized doctors, hospitals and other providers are paid a Tricare allowable charge for each service performed. Individuals may use only Tricare authorized providers, and they pay more than under other Tricare plans. Certain procedures also require pre-authorization. For civilian doctor visits, cost shares are a percentage of the allowable charge. Retirees and other eligible beneficiaries pay 25 percent; active-duty family members pay 20 percent.

Standard patients must meet outpatient deductibles before the government shares costs. 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.

In September 2009, Tricare waived cost shares for preventive screenings for colorectal cancer, breast cancer, cervical cancer and prostate cancer as well as immunizations and well-child visits for children under 6 years of age.

Contact: www.tricare.mil/mybenefit/ home/overview/Plans