TRICARE Prime vs Select: Which Plan is Right for You?
TRICARE Prime is an HMO-style managed care plan with lower out-of-pocket costs but requires using network providers and referrals for specialists. TRICARE Select is a PPO-style plan offering greater flexibility to see any TRICARE-authorized provider without referrals, but with higher cost-sharing. For 2026, TRICARE Prime retirees pay $765/year family enrollment with $26 primary care copays and a $3,000 catastrophic cap. TRICARE Select retirees pay $375/year enrollment plus 20% cost-share after a $300 family deductible, with a $4,381 cap.
TRICARE Prime
HMO-Style Managed Care- Lower out-of-pocket costs
- No deductible
- Requires referrals
- Must use network providers
TRICARE Select
PPO-Style Self-Managed- No referrals needed
- See any TRICARE provider
- Has deductible
- Higher cost-sharing (20-25%)
Complete Cost Comparison: Prime vs Select (2026)
Side-by-side comparison for Group A retirees (retired before January 1, 2018).
| Cost Category | TRICARE Prime | TRICARE Select |
|---|---|---|
| Annual Enrollment (Individual) | $382 | $187 ✓ |
| Annual Enrollment (Family) | $765 | $375 ✓ |
| Annual Deductible (Individual) | $0 ✓ | $150 |
| Annual Deductible (Family) | $0 ✓ | $300 |
| Primary Care Visit | $26 copay ✓ | 20% cost-share |
| Specialist Visit | $39 copay ✓ | 20% cost-share |
| Urgent Care | $39 copay | 20% cost-share |
| Emergency Room | $79 copay ✓ | 25% cost-share |
| Inpatient Hospital (per admission) | $198 | $250/day (min $25) |
| Outpatient Surgery | $79 copay ✓ | 20% cost-share |
| Catastrophic Cap | $3,000 ✓ | $4,381 |
| Referrals Required? | Yes | No ✓ |
| Can See Any Provider? | Network only | Yes ✓ |
* Group B retirees (retired on/after January 1, 2018) have different enrollment fees. Active duty families pay $0 enrollment for both plans.
Active Duty Family Costs (2026)
Active duty service members are automatically enrolled in Prime at no cost. Family members can choose Prime or Select.
| Cost Category | Prime (Family) | Select (Family) |
|---|---|---|
| Annual Enrollment | $0 | $0 |
| Annual Deductible | $0 | $150 / $300 |
| Primary Care Visit | $0 | 15% cost-share |
| Specialist Visit | $0 | 15% cost-share |
| Emergency Room | $0 | 20% cost-share |
| Catastrophic Cap | $1,000 | $1,000 |
Pros and Cons
TRICARE Prime
Pros
- Lower overall costs - Fixed copays are predictable and usually cheaper than percentage cost-shares
- No deductible - Coverage starts immediately without meeting a deductible first
- Lower catastrophic cap - $3,000 vs $4,381 max out-of-pocket
- Care coordination - Your PCM manages and coordinates all your healthcare
- Priority at MTFs - Prime enrollees get priority appointments at military facilities
Cons
- Referrals required - Must get approval from PCM to see specialists
- Network restrictions - Must use network providers (except emergencies)
- Higher enrollment fees - $765/year family vs $375 for Select
- Geographic limits - Only available in Prime Service Areas (near military bases)
TRICARE Select
Pros
- No referrals needed - See any specialist directly without approval
- Provider freedom - See any TRICARE-authorized provider nationwide
- Lower enrollment fees - $375/year family vs $765 for Prime
- Available everywhere - No geographic restrictions like Prime
- Good for minimal care - If healthy, lower enrollment + low usage = savings
Cons
- Deductible required - Must pay $150-$300 before coverage kicks in
- Higher cost-sharing - 20-25% of costs vs fixed copays
- Higher catastrophic cap - $4,381 vs $3,000 max out-of-pocket
- Unpredictable costs - Percentage-based costs vary with service prices
Which TRICARE Plan Should You Choose?
Use this guide to help determine which plan fits your situation best.
Choose TRICARE Prime If:
- You live near a military base or in a Prime Service Area
- You want the lowest possible out-of-pocket costs
- You have chronic conditions requiring regular care
- You prefer predictable fixed copays over percentages
- You don't mind getting referrals for specialists
- You want priority access at military treatment facilities
- You appreciate having a care coordinator (PCM)
Choose TRICARE Select If:
- You live far from military bases or travel frequently
- You want freedom to choose any provider without restrictions
- You see multiple specialists and don't want referral hassles
- Your family is generally healthy with minimal care needs
- You have a specific doctor you want to keep seeing
- You prefer to manage your own care without a PCM
- You value flexibility over cost savings
How to Switch Between Prime and Select
You can change plans during Open Season or after a Qualifying Life Event.
TRICARE Open Season
The annual enrollment period when you can switch plans without a qualifying event.
- When: Mid-November to mid-December (dates vary yearly)
- Effective: January 1 of the following year
- How: Use milConnect or contact regional contractor
Qualifying Life Events (QLE)
You can switch plans within 90 days of these qualifying events:
- PCS (Permanent Change of Station) move
- Marriage, divorce, or legal separation
- Birth or adoption of a child
- Loss of other health coverage
- Retirement or separation from service
Frequently Asked Questions
Common questions about choosing between TRICARE Prime and Select.
What is the difference between TRICARE Prime and Select?
TRICARE Prime is an HMO-style managed care plan with lower out-of-pocket costs but requires using network providers and referrals for specialists. TRICARE Select is a PPO-style plan with more flexibility to see any TRICARE-authorized provider without referrals, but has higher cost-sharing (typically 20-25% after deductible).
Which TRICARE plan is cheaper: Prime or Select?
TRICARE Prime generally has lower overall costs with higher enrollment fees but no deductibles and lower copays. TRICARE Select has lower enrollment fees but requires meeting a deductible and paying 20-25% cost-shares. For families with high healthcare usage, Prime is usually cheaper. For healthy families with minimal care needs, Select may cost less.
Do I need referrals with TRICARE Select?
No, TRICARE Select does not require referrals to see specialists. You can self-refer to any TRICARE-authorized provider. This is one of the main advantages of Select over Prime, which requires referrals from your Primary Care Manager (PCM) for specialty care.
Can I switch between TRICARE Prime and Select?
Yes, you can switch between TRICARE Prime and Select during TRICARE Open Season (typically mid-November to mid-December) with changes effective January 1. You can also switch after a Qualifying Life Event (QLE) such as PCS move, marriage, birth of child, or loss of other coverage.
What is a Primary Care Manager (PCM) in TRICARE Prime?
A Primary Care Manager (PCM) is your assigned primary care provider in TRICARE Prime. Your PCM coordinates all your care, provides routine medical services, and issues referrals when you need to see specialists. PCMs can be at military treatment facilities or civilian network providers.
Is TRICARE Prime available everywhere?
TRICARE Prime is available in Prime Service Areas (PSAs), which are typically within 40 miles of a military treatment facility. If you live outside a PSA, you may only be eligible for TRICARE Prime Remote (active duty) or TRICARE Select. Check the TRICARE website to verify Prime availability in your area.
What is the catastrophic cap for TRICARE Prime vs Select?
For 2026, the catastrophic cap (maximum out-of-pocket) for retirees is $3,000 for TRICARE Prime and $4,381 for TRICARE Select. Active duty family members have a $1,000 cap for both plans. Once you reach the cap, TRICARE pays 100% of covered services for the rest of the year.
Can I use any doctor with TRICARE Prime?
No, TRICARE Prime requires you to use network providers and get referrals for specialists. However, emergency care is always covered regardless of provider. If you want freedom to see any doctor without referrals, TRICARE Select is a better choice.
Which TRICARE plan is best for military retirees?
It depends on your healthcare needs and preferences. TRICARE Prime is best for retirees who want lower costs, don't mind referrals, and live near military facilities. TRICARE Select is best for retirees who want flexibility, see multiple specialists, or live far from military bases.
Do active duty families pay for TRICARE Prime or Select?
Active duty family members pay $0 enrollment fees for both TRICARE Prime and TRICARE Select. However, Prime has $0 copays for most care while Select has small cost-shares (15-20%). Active duty service members themselves are automatically enrolled in Prime at no cost.
Disclaimer: Navitize is not affiliated with, endorsed by, or connected to TRICARE, the Defense Health Agency, the Department of Defense, or any branch of the U.S. military. This guide is compiled from publicly available information for educational purposes only and does not constitute official TRICARE guidance. For official information, visit tricare.mil. TRICARE coverage, costs, and eligibility rules may change. Always verify current information with official sources before making healthcare decisions.