What is TRICARE? Military Health Insurance Explained
TRICARE is the health care program for uniformed service members, retirees, and their families worldwide. Managed by the Defense Health Agency (DHA), TRICARE provides comprehensive medical coverage including doctor visits, hospital stays, prescriptions, mental health services, and preventive care. The program serves over 9.6 million beneficiaries through a combination of military treatment facilities and civilian provider networks. TRICARE offers multiple plan options including TRICARE Prime (HMO-style), TRICARE Select (PPO-style), TRICARE For Life (Medicare supplement), and specialized plans for Guard, Reserve, and young adults.
How Does TRICARE Work?
TRICARE operates as a managed health care program that combines resources from military hospitals and clinics with civilian health care providers.
Military Treatment Facilities (MTFs)
Military hospitals and clinics on bases provide care at no cost to active duty members. Family members and retirees can also use MTFs when space is available (space-available care).
- No out-of-pocket costs for active duty
- Primary care managers (PCMs) assigned here
- Pharmacy, lab, and specialty services
Civilian Provider Networks
TRICARE contracts with regional contractors who maintain networks of civilian doctors, hospitals, and pharmacies. This expands access beyond military bases.
- TRICARE East: Humana Military
- TRICARE West: Health Net Federal Services
- TRICARE Overseas: International SOS
How to Use TRICARE: Step by Step
Verify Eligibility
Confirm you're registered in DEERS with correct info
Choose a Plan
Select Prime, Select, or other plan based on your status
Enroll
Enroll through milConnect or your regional contractor
Get Care
Visit MTFs or network providers; pay your cost-share
Who is Eligible for TRICARE?
TRICARE eligibility is determined by your military status and relationship to a service member. All beneficiaries must be registered in DEERS.
Eligible for TRICARE
- Active Duty Service Members
All branches: Army, Navy, Air Force, Marines, Coast Guard, Space Force
- Active Duty Family Members
Spouse and children (until age 21, or 23 if full-time student)
- Retired Service Members
20+ years of service or medically retired
- Retiree Family Members
Spouse and eligible children of retirees
- National Guard & Reserve
When activated, or through TRS/TRR premium plans
- Surviving Family Members
Of service members who died on active duty or in retirement
- Medal of Honor Recipients
And their eligible family members
NOT Eligible for TRICARE
- Civilians with No Military Connection
TRICARE is exclusively for military-connected individuals
- Veterans Who Didn't Retire
Those who separated before 20 years (may use VA instead)
- Former Spouses (Usually)
Unless qualifying under 20/20/20 or 20/20/15 rule
- Parents of Service Members
Only spouse and children are covered, not parents
- Children Over Age 21/23
Unless enrolled in TRICARE Young Adult (ages 21-26)
- Those Not in DEERS
Must be registered and current in DEERS system
What Does TRICARE Cover?
TRICARE provides comprehensive health coverage similar to high-quality employer health plans.
Medical Care
- • Primary care visits
- • Specialist consultations
- • Preventive care & screenings
- • Emergency room visits
- • Urgent care
- • Hospital stays
- • Surgery (inpatient & outpatient)
- • Lab tests & X-rays
Pharmacy
- • Generic medications
- • Brand-name drugs
- • Specialty medications
- • Home delivery option
- • MTF pharmacy (lowest cost)
- • Retail pharmacy network
- • Mail-order (90-day supply)
- • Compound medications
Mental Health
- • Outpatient therapy
- • Psychiatric care
- • Substance abuse treatment
- • Inpatient mental health
- • Crisis intervention
- • Applied Behavior Analysis (ABA)
- • Family counseling
- • PTSD treatment
Maternity & Pediatric
- • Prenatal care
- • Labor & delivery
- • Postnatal care
- • Well-child visits
- • Immunizations
- • Breast pumps
- • Newborn care
Additional Services
- • Physical therapy
- • Occupational therapy
- • Speech therapy
- • Durable medical equipment
- • Prosthetics
- • Home health care
- • Hospice care
Limited/Not Covered
- • Cosmetic surgery (usually)
- • Experimental treatments
- • Long-term care/custodial
- • Most dental (separate plan)
- • Routine vision (separate)
- • Weight loss surgery (limited)
- • Infertility (limited)
Types of TRICARE Plans
TRICARE offers different plans based on your military status and coverage needs.
| Plan | Who It's For | Type | Key Feature |
|---|---|---|---|
| TRICARE Prime | Active duty, retirees, families | HMO | Lowest cost, requires referrals |
| TRICARE Select | Active duty families, retirees | PPO | More flexibility, no referrals |
| TRICARE For Life | Retirees 65+ with Medicare | Medicare supplement | Near-zero out-of-pocket |
| TRICARE Reserve Select | Guard & Reserve (drilling) | Premium-based | $57-287/month premiums |
| TRICARE Retired Reserve | Gray area retirees (under 60) | Premium-based | Higher premiums, full coverage |
| TRICARE Young Adult | Adult children 21-26 | Premium-based | $363-794/month |
TRICARE vs Other Health Insurance
How does TRICARE compare to civilian health insurance options?
| Feature | TRICARE (Retiree) | Typical Employer Plan | ACA Marketplace (Silver) |
|---|---|---|---|
| Annual Premium | $375-$765 | ~$6,575 | ~$6,000+ |
| Deductible | $0-$300 | ~$1,500 | ~$3,000 |
| Out-of-Pocket Max | $3,000-$4,381 | ~$6,000 | ~$9,000 |
| Network | National + Overseas | Regional | Regional |
| Portability | Moves with you | Tied to job | State-based |
Bottom Line: TRICARE is Excellent Value
For those who qualify, TRICARE offers some of the best health coverage available in the United States. Retirees often pay 90% less in premiums than comparable civilian plans while receiving comprehensive benefits with lower out-of-pocket costs.
Frequently Asked Questions
Common questions about what TRICARE is and how it works.
What is TRICARE?
TRICARE is the health care program serving uniformed service members, retirees, and their families worldwide. It is managed by the Defense Health Agency (DHA) and provides comprehensive medical, dental, and pharmacy coverage to over 9.6 million beneficiaries.
How does TRICARE work?
TRICARE works by combining military hospitals and clinics with civilian provider networks. You choose a plan (Prime, Select, etc.), enroll through milConnect, get care from authorized providers, and pay your share of costs based on your plan and beneficiary category. TRICARE coordinates benefits if you have other insurance.
What type of insurance is TRICARE?
TRICARE is a government-sponsored health insurance program, similar to an employer health plan but for military families. It offers both HMO-style (TRICARE Prime) and PPO-style (TRICARE Select) options, plus specialized plans for retirees, reservists, and young adults.
Does TRICARE still exist?
Yes, TRICARE still exists and remains the primary health care program for U.S. military members and their families. It was established in 1995 and continues to serve over 9.6 million beneficiaries worldwide through various plan options.
Who is eligible for TRICARE?
TRICARE eligibility includes: active duty service members and their dependents, retired service members and their dependents, National Guard and Reserve members (with qualifying plans), Medal of Honor recipients, and certain surviving family members. Eligibility is verified through DEERS.
What does TRICARE cover?
TRICARE covers comprehensive health services including: doctor visits, hospital stays, emergency care, preventive care, mental health services, prescription drugs, maternity care, surgery, lab tests, X-rays, and medical equipment. Coverage details vary by plan type.
Is TRICARE free?
TRICARE is free for active duty service members (TRICARE Prime). Active duty family members pay $0 enrollment with minimal copays. Retirees pay annual enrollment fees ($187-$765 depending on plan) plus copays or cost-shares. Reserve members pay monthly premiums for TRICARE Reserve Select.
Can civilians get TRICARE?
No, civilians cannot get TRICARE unless they are eligible dependents of military members or retirees. TRICARE is exclusively for military-connected beneficiaries who are registered in DEERS (Defense Enrollment Eligibility Reporting System).
What is the difference between TRICARE and VA healthcare?
TRICARE covers active duty members, retirees, and their families. VA healthcare is only for veterans (those who served and separated). A military retiree can have both TRICARE and VA benefits. Active duty members use TRICARE, not VA. Spouses and children are only eligible for TRICARE, not VA.
Why are some doctors dropping TRICARE?
Some doctors drop TRICARE due to lower reimbursement rates compared to commercial insurance and administrative burden. However, TRICARE maintains extensive provider networks through regional contractors (Humana Military for East, Health Net for West), and most areas have adequate provider availability.
Learn More About TRICARE
Continue exploring our TRICARE guides to understand your specific situation.
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.