Welcome Logout

2024 Cost Information for Ambulance Services

Note: Visit our Copayment and Cost-Share Information page to view 2023 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.
  • 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.

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.

Note: Cost-shares are a percentage of the contracted rate for network providers and the maximum TRICARE allowable for non-network providers on certain types of services.

Outpatient costs are applied to the following transports:

  • Beneficiary's residence, accident scene or other location to a civilian, military or VA hospital, or skilled nursing facility (SNF)
  • Hospital or SNF to the beneficiary's residence

Inpatient costs are applied to the following transports:

  • Between hospitals or SNFs
  • Emergency room or civilian hospital to a military or VA hospital
  • Emergency room to a hospital more capable of providing the required level of care

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

Active Duty Family Members Retirees and Their Family Members

Ground:

Group A:

Outpatient: $0
Inpatient: $0

Group B:

Outpatient: $0
Inpatient: $0

Air:

Group A:

Outpatient: $0
Inpatient: $0

Group B:

Outpatient: $0
Inpatient: $0

Ground: 

Group A:

Outpatient: $50
Inpatient: 25%

Group B:

Outpatient: $50
Inpatient: 25%

Air: 

Group A:

Outpatient: $20
Inpatient: 25%

Group B:

Outpatient: $20
Inpatient: 25%

TRICARE Select (not including TRICARE Young Adult)

Active Duty Family Members Retirees and Their Family Members

Ground: 

Group A: 

Outpatient:

Network Provider: $79
Non-Network Provider: 20%

Inpatient: 20%

Group B:

Outpatient:

Network Provider: $18
Non-Network Provider: 20%

Inpatient: 20%

Air: 

Group A: 

Outpatient:

Network Provider: 20%
Non-Network Provider: 20%

Inpatient: 20%

Group B:

Outpatient:

Network Provider: 20%
Non-Network Provider: 20%

Inpatient: 20%

Ground: 

Group A:

Outpatient:

Network Provider: $106
Non-Network Provider: 25%

Inpatient: 25%

Group B:

Outpatient:

Network Provider: $75
Non-Network Provider: 25%

Inpatient: 25%

Air: 

Group A:

Outpatient:

Network Provider: 25%
Non-Network Provider: 25%

Inpatient: 25%

Group B:

Outpatient:

Network Provider: 25%
Non-Network Provider: 25%

Inpatient: 25%

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

TRS TRR

Ground: 

Outpatient:

Network Provider: $18
Non-Network Provider: 20%

Inpatient: 20%

Air: 

Outpatient:

Network Provider: 20%
Non-Network Provider: 20%

Inpatient: 20%

Ground:

Outpatient:

Network Provider: $75
Non-Network Provider: 25%

Inpatient: 25%

Air:

Outpatient:

Network Provider: 25%
Non-Network Provider: 25%

Inpatient: 25%

   

TRICARE Young Adult (TYA)

TYA Prime TYA Select
Active Duty Family Members Retiree Family Members Active Duty Family Members Retiree Family Members

Ground: 

Outpatient: $0
Inpatient: $0

Air:  

Outpatient: $0
Inpatient: $0

Ground:   

Outpatient: $50
Inpatient: 25%

Air   

Outpatient: $20
Inpatient: 25%

Ground: 

Outpatient:

Network Provider: $18
Non-Network Provider: 20%

Inpatient: 20%

Air: 

Outpatient:

Network Provider: 20%
Non-Network Provider: 20%

Inpatient: 20%

Ground:

Outpatient:

Network Provider: $75
Non-Network Provider: 25%

Inpatient: 25%

Air: 

Outpatient:

Network Provider: 25%
Non-Network Provider: 25%

Inpatient: 25%