TRICARE, Explained

THE MAPWho gets which plan

TRICARE is not one plan. It is a set of plans, and your choices depend on your category. TRICARE says it is a health care program, not an agency: the sponsor's uniformed service decides who is eligible and reports it in the Defense Enrollment Eligibility Reporting System (DEERS), which you can check in milConnect.

Survivors, qualified former spouses, Medal of Honor recipients, and some dependent parents have their own rules; TRICARE's eligibility page walks each category.

PRIME OR SELECTThe trade, in two lines each

TRICARE Prime is managed care in Prime Service Areas. You have an assigned primary care manager who provides most of your care and refers you to specialists. TRICARE describes it as fewer out-of-pocket costs and less freedom of choice. Retirees and their families lose eligibility for Prime when they become eligible for Medicare based on age.

TRICARE Select is a self-managed plan: you book with any TRICARE-authorized provider, and referrals are not required for most primary and specialty visits, though some services need pre-authorization. You pay an enrollment fee (for retirees), a yearly deductible, and copays or cost-shares. TRICARE notes it may fit if you cannot use Prime where you live, if you have other health insurance such as an employer plan, or if you want to keep a provider outside the network.

2026 COSTSWhat you pay, from TRICARE's own sheet

Costs depend on your plan and your group. You are in Group A if your sponsor's initial enlistment or appointment was before January 1, 2018, and Group B if it was on or after that date. These are the calendar-year 2026 figures from TRICARE's 2026 Costs and Fees sheet; TRICARE had not posted 2027 costs when we checked.

Active duty families pay nothing in Prime for network care. In Select, Group A pays a $50 or $150 individual deductible depending on the sponsor's pay grade (E-4 and below, or E-5 and above) with a $1,000 family catastrophic cap; Group B pays $66 or $198 with a $1,324 cap.

Pharmacy, 2026: covered drugs are $0 at a military pharmacy. Through TRICARE Pharmacy Home Delivery, up to a 90-day supply is $14 generic, $44 brand-name formulary, and $85 non-formulary; at a retail network pharmacy, up to a 30-day supply is $16, $48, and $85. People on active duty pay nothing for covered drugs at military, home delivery, or retail network pharmacies.

CHANGING PLANSOpen Season and life events

TRICARE Open Season for 2027 coverage runs November 9 to December 8, 2026, and changes take effect January 1, 2027. If you are happy with your plan, you do nothing: it continues. Open Season applies to TRICARE Prime options and TRICARE Select. It does not apply to people on active duty, to TRICARE For Life, or to people enrolled in Reserve Select, Retired Reserve, or Young Adult.

Outside Open Season, a Qualifying Life Event opens a 90-day window to change plans: marriage, divorce, a birth or adoption, retiring or separating, moving, activating or deactivating, becoming eligible for Medicare, and others on TRICARE's list. Update DEERS first; whenever you make the change in those 90 days, coverage starts on the date of the event.

TURNING 65TRICARE For Life, in four facts

TRICARE For Life is Medicare-wraparound coverage for TRICARE-eligible people who have Medicare Part A and Part B, regardless of age or where they live. There is no enrollment form: coverage starts the first day both Medicare parts are in effect, and you must pay the Medicare Part B premium. It covers the person with Medicare, not their family members, who keep their own TRICARE eligibility. Medicare pays first, TRICARE pays after it, and for services both cover you generally owe nothing out of pocket.

One recent change: as of August 31, 2025, the TRICARE pharmacy benefit no longer covers weight-loss drugs for TRICARE For Life beneficiaries when obesity is the primary diagnosis. TRICARE's page notes that beginning July 1, 2026, Medicare Part D covers certain weight-loss drugs under the Medicare GLP-1 Bridge Program. The Medicare decisions at 65 are covered in our aging and long-term care guide.

GUARD, RESERVE, FEDERAL JOBSWhen you have other insurance

Reserve Select and FEHB. TRICARE Reserve Select is for members of the Selected Reserve who are not on active duty orders for more than 30 days, not covered by the Transitional Assistance Management Program, and not eligible for or enrolled in the Federal Employees Health Benefits Program. So a reservist who works a federal civilian job and is eligible for FEHB cannot buy Reserve Select on their own. A family member of a reservist who does qualify can still be covered through that reservist's enrollment, and Individual Ready Reserve members do not qualify.

Who pays first. By law, TRICARE pays after all other health insurance, such as an employer plan or FEHB, except Medicaid, TRICARE supplements, and a few government programs. Your other plan processes the claim first and TRICARE second, and you must follow your other plan's rules, because TRICARE can deny a claim your other plan denied for not following them. Tell your regional contractor and your doctors about any other insurance you have.

Military retirees who are federal annuitants. OPM says annuitants can apply at any time to suspend FEHB coverage to use TRICARE. The suspension form comes from OPM's Retirement Information Office at 888-767-6738, with proof of TRICARE eligibility around the date you choose. OPM's eligibility page says a suspended annuitant can reinstate FEHB during Open Season, or right away after involuntarily losing the other coverage, and that time covered by TRICARE counts toward the five years of FEHB needed to keep it in retirement, as long as you are enrolled in FEHB when you retire. Our FERS guide covers that five-year rule. Our FEHB plan comparison and federal employees page cover the FEHB side.

DENTAL AND VISIONSeparate plans, separate doors

TRICARE health plans do not include routine dental care, and dental depends on who you are. People on active duty, and Guard and Reserve members on orders for more than 30 days, use the Active Duty Dental Program. Active duty families and Guard and Reserve members who are not on orders can buy the TRICARE Dental Program from United Concordia. Retirees and their families can buy FEDVIP dental through BENEFEDS.

For vision, FEDVIP vision is open to active duty families and to retirees and their families enrolled in a TRICARE health plan; our FEDVIP comparison lays out those plans and premiums side by side. TRICARE Young Adult does not include dental or vision.

WHO TO CALLThe doors that answer real cases

Your regional contractor handles enrollment, referrals, authorizations, and claims. In the U.S., that is Humana Military in the East Region, 800-444-5445, and TriWest Healthcare Alliance in the West Region, 888-874-9378. Overseas, it is International SOS through tricare-overseas.com. For pharmacy, Express Scripts runs the TRICARE Pharmacy Program at 877-363-1303. TRICARE For Life claims go through WPS Government Services; start at tricare.mil/tfl. Your DEERS record, which every plan depends on, is in milConnect.