TRICARE (Military Health System)

TRICARE is the healthcare program of the United States Department of Defense Military Health System, providing health coverage to active-duty service members, retirees, their families, and survivors. TRICARE serves approximately 9.6 million beneficiaries worldwide and is one of the most comprehensive health insurance programs in the country.

TRICARE offers several plan options that vary by beneficiary category and preference. Active-duty service members receive TRICARE Prime at no cost, while retirees and family members can choose between TRICARE Prime (managed care), TRICARE Select (PPO-style), and TRICARE For Life (Medicare supplement for retirees 65+). Reservists and National Guard members have access to TRICARE Reserve Select and TRICARE Retired Reserve.

Care is delivered through military treatment facilities (MTFs) such as military hospitals and clinics, as well as a large civilian provider network managed by regional contractors. TRICARE covers beneficiaries both within the United States and overseas, making it unique among health insurance programs in its global reach.

What TRICARE Covers

• Preventive care and annual health assessments at no cost
• Primary care and specialist visits
• Inpatient and outpatient hospital care
• Emergency and urgent care
• Prescription drugs through military pharmacies, retail pharmacies, and mail-order (TRICARE Pharmacy Program)
• Mental and behavioral health services
• Maternity care including prenatal, delivery, and postpartum
• Surgery and anesthesia
• Laboratory and diagnostic imaging
• Durable medical equipment and prosthetics
• Rehabilitation services (physical, occupational, speech therapy)
• Vision: annual eye exams covered; TRICARE does not cover routine eyeglasses for most beneficiaries
• Dental: separate TRICARE Dental Program (TRDP) for family members; active duty covered by military dental clinics

TRICARE Plan Options

• TRICARE Prime: Managed care HMO-style plan with PCM and referrals
• TRICARE Select: PPO-style plan with freedom to see any TRICARE-authorized provider
• TRICARE For Life: Medicare supplement for beneficiaries with Medicare Parts A and B
• TRICARE Reserve Select (TRS): For Selected Reserve members and families
• TRICARE Young Adult (TYA): For dependent children aged 21-26

Who Is Eligible for TRICARE

• Active-Duty Service Members (ADSMs): Automatically enrolled in TRICARE Prime at no cost
• Active-Duty Family Members: Eligible for TRICARE Prime or TRICARE Select
• Retired Service Members: Eligible for TRICARE Prime, Select, or For Life (if Medicare-eligible)
• Retired Family Members: Same options as retirees
• National Guard and Reserve Members: TRICARE Reserve Select when in drilling status
• Medal of Honor Recipients: Eligible for TRICARE Prime
• Survivors: Surviving spouses and children of deceased service members

Eligibility is managed through the Defense Enrollment Eligibility Reporting System (DEERS). All beneficiaries must be registered in DEERS to receive TRICARE benefits. Sponsors must ensure their family members' DEERS records are up to date.

2025/2026 TRICARE Costs

TRICARE Prime

• Active Duty: $0 premiums, $0 copays, $0 deductible
• Retirees (Individual): $183.94/year enrollment fee; $0 deductible; $30 copay for specialist visits
• Retirees (Family): $367.87/year enrollment fee

TRICARE Select

• Active-Duty Family (Group A): $0 premiums; $150 individual / $300 family deductible; 15% cost-share for in-network care
• Retirees (Group B, Individual): $176.06/month; $150 deductible; 20% cost-share in-network
• Retirees (Group B, Family): $440.16/month; $300 family deductible
• Catastrophic Cap: $1,000/year (Group A) or $3,500/year (Group B)

TRICARE Pharmacy

• Military Pharmacy: $0 for all prescriptions
• Mail-Order (Home Delivery): $0 generic / $29 brand / $65 non-formulary (90-day supply)
• Retail Pharmacy: $14 generic / $38 brand / $68 non-formulary (30-day supply)

How to Enroll

• Active Duty: Automatically enrolled in TRICARE Prime upon entering service
• Family Members/Retirees: Must register in DEERS and select a plan
• TRICARE Prime: Enroll online at tricare.mil, by phone (1-800-444-5445 for Humana Military East, 1-844-866-9378 for Health Net Federal Services West), or at a TRICARE Service Center
• TRICARE Select: Enroll through milConnect (milconnect.dmdc.osd.mil)
• Qualifying Life Events: Marriage, birth, relocation, retirement — trigger enrollment opportunities
• Open Season: Annual Federal Benefits Open Season (mid-November to mid-December)

Beneficiaries overseas are covered by TRICARE Overseas Program (TOP) administered by International SOS Government Medical Services.

Pros

• Free or extremely low-cost healthcare for active-duty members and their families
• Comprehensive coverage with low copays, deductibles, and catastrophic caps
• Global coverage for military families stationed worldwide
• Free prescriptions at military pharmacies
• No enrollment fee for active-duty members; low enrollment for retirees
• TRICARE For Life provides excellent supplemental coverage with Medicare

Cons

• TRICARE Prime requires PCM referrals for specialist care
• Military treatment facility availability varies by location
• Civilian provider networks may be limited in some regions
• Retiree costs for TRICARE Select have increased significantly in recent years
• Dental coverage requires a separate program and premium
• Prior authorization required for many services, which can delay treatment