Free interactive tool

Out-of-Pocket Cost Estimator

Select your TRICARE plan, the level of care, and your network status. Get an estimate of what you will likely pay out of pocket in real dollar ranges, not just percentages, based on published TRICARE cost-share schedules.

No name or personal details required

Who is seeking care? Affects your deductible and cost-share rate

Level of care Not sure? Read the guide

Network status Ask the facility directly. Affects costs significantly.

Estimated costs for your situation

Based on published TRICARE cost-share schedules

Estimated cost breakdown

Estimates only

Cost element	Estimated amount	Notes
Annual deductible	See result	Per person or family
Cost-share percentage	See result	Of TRICARE allowed charges
Estimated daily cost-share	See result	Based on typical allowed charge ranges
Estimated total cost-share	See result	For a typical course of treatment
Annual catastrophic cap	See result	Maximum out-of-pocket per benefit year

What the catastrophic cap means

Once you reach your annual catastrophic cap, TRICARE pays 100% of covered costs for the rest of the benefit year. This is a meaningful protection for extended or multiple courses of treatment in the same year.

Network impact

In-network care uses the lower cost-share rates shown. Out-of-network care under Select and Reserve Select carries significantly higher cost-shares. Under Prime, out-of-network care for non-emergencies is generally not covered except through point-of-service provisions.

Sources: TRICARE costs and fees (tricare.mil) Substance use disorder coverage

All figures are estimates based on published TRICARE cost-share schedules and typical allowed charge ranges for San Antonio area providers. Your actual costs depend on your deductible status at the time of treatment, your progress toward the catastrophic cap, the specific facility's contract rates, and the number of days TRICARE authorizes. Always confirm your expected costs by calling TriWest directly before enrolling in any program. These estimates are provided for planning purposes only and do not constitute a benefits verification.

View treatment centers in San Antonio → How to verify coverage →

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How costs work under TRICARE

Deductible firstYou pay the annual deductible before cost-sharing begins. Deductibles reset each benefit year.

Cost-share on allowed chargesTRICARE sets an allowed charge for each service. You pay your percentage of that, not the full billed amount.

Catastrophic cap protects youOnce you hit the annual cap, TRICARE covers 100% of authorized care for the rest of the year.

In-network saves moneyIn-network providers have negotiated rates, so the allowed charge is lower and your cost-share is lower too.

Getting an exact cost before enrolling

Ask any treatment center to run a benefits verification with TriWest before you agree to anything.
Request a written estimate of expected cost-share and authorized days before your admission date.
Check your current deductible status: if you have already met your deductible this year, your costs will be lower.
Ask where you stand toward your catastrophic cap. If you are close, you may hit zero cost-share quickly.

Related tools and guides

Coverage checker In vs out of network costs Out-of-pocket guide by plan Prior authorization timeline

Out-of-Pocket Cost Estimator

Active-duty service members pay no cost-share

Estimated cost breakdown

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