What is a catastrophic cap in TRICARE?

A catastrophic cap in TRICARE refers to the maximum out-of-pocket yearly expense that beneficiaries are required to pay for covered services. Once beneficiaries reach this cap, TRICARE covers 100% of the costs for additional medically necessary services for the remainder of the calendar year. This limit is designed to protect members from excessively high healthcare costs and ensure that they don’t face financial hardship due to unexpected health-related expenses.

The concept of a catastrophic cap is particularly important for managing health care budgets, as it provides a safety net for beneficiaries. It helps in planning for medical expenses and offers peace of mind, knowing there is a ceiling on what they would need to spend out-of-pocket.