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TRICARE Clinics: A Guide to Military & Civilian Care

2026 guide to TRICARE clinics: Learn the difference between MTF and civilian clinics, referral rules for Prime vs. Select, and 2026 copay rates.

TRICARE Clinics: A Guide to Military & Civilian Care

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## Quick answer TRICARE beneficiaries can receive care at two types of clinics: military clinics located on bases (MTFs) and private-sector civilian clinics. If you are enrolled in TRICARE Prime, you are usually assigned to a specific primary care clinic; if you have TRICARE Select, you can visit almost any TRICARE-authorized civilian clinic, though your out-of-pocket costs will be lower if the provider is in-network.

In detail

### Types of Clinics in the TRICARE Network Where you go for care depends largely on your specific TRICARE plan and your location.

* **Military Medical Treatment Facilities (MTFs):** These are clinics located on military installations. They are staffed by military and civilian Department of Defense employees. Active duty service members (ADSMs) have first priority at these clinics. * **TRICARE-Authorized Civilian Clinics:** These are private-sector medical offices. They are divided into two categories: * **Network Clinics:** Have a contract with Humana Military (East Region) or TriWest (West Region) to provide care at pre-negotiated rates. * **Non-Network Clinics:** Do not have a contract but are authorized to see TRICARE patients. These usually result in higher "point-of-service" charges or non-participating provider fees. * **Urgent Care Clinics:** These clinics handle non-life-threatening injuries or illnesses that require immediate attention. Most TRICARE Prime enrollees (excluding active duty) can visit a network urgent care clinic without a referral.

### Clinic Access by Plan | Plan Type | Clinic Access Rules | | :--- | :--- | | **TRICARE Prime** | Primarily assigned to an MTF clinic; requires a referral from your Primary Care Manager (PCM) for specialty clinics. | | **TRICARE Select** | Can visit any TRICARE-authorized civilian clinic; no referrals needed for most services, but costs are lower in-network. | | **TRICARE For Life** | Can visit any clinic that accepts Medicare and TRICARE. |

### 2026 Costs at Civilian Clinics Costs for clinic visits are determined by your "group" (Group A joined before 2018, Group B joined after) and your sponsor's status. Below are examples of **2026 rates** for common clinic visits:

* **Active Duty Family Members (Prime):** $0 copay at assigned clinics. * **Retirees (Select/Group A):** Roughly $37 per primary care visit and $50 per specialty clinic visit (2026 estimates). * **Urgent Care (Retirees):** Approximately $40–$60 per visit at a network clinic.

### The Referral Process For specialty clinics (like dermatology or cardiology), your PCM at your primary clinic must submit a referral request to either Humana Military (East) or TriWest (West). If you bypass this process while on a Prime plan, you will be charged "Point-of-Service" fees, which include a $300 deductible and 50% of the allowed cost.

## Who this applies to * **Active Duty Service Members:** Restricted almost exclusively to MTF clinics; must have a "fitness-for-duty" review for any private-sector clinic visits. * **Active Duty Family Members:** Have the choice between MTF clinics (if space is available) or civilian network clinics via TRICARE Select or Prime. * **Retirees and their Families:** Often transitioned to civilian clinics if MTF capacity is reached. * **National Guard and Reserve:** Use civilian clinics through TRICARE Reserve Select (TRS).

Common scenarios

**Scenario 1: The Prime Referral** Jane is an active duty spouse in San Diego (West Region) enrolled in TRICARE Prime. Her primary clinic is at Naval Medical Center San Diego. She needs to see an allergist. Her PCM at the Navy clinic submits a referral. TriWest approves her to see a civilian allergy clinic in the community. Because she is Prime and followed the referral process, her copay at the civilian clinic is **$0 (2026 rates)**.

**Scenario 2: The Select Choice** Mark is a retired veteran in Florida (East Region) enrolled in TRICARE Select. He prefers a specific private-sector family clinic near his house that is in the Humana Military network. He makes an appointment directly without a referral. As a Group A retiree, he pays a **$37 copay** for the office visit after meeting his annual deductible.

**Scenario 3: Urgent Care Needs** Sarah, a TRICARE Reserve Select member, gets a minor burn on a Saturday. She goes to a local "MinuteClinic" or similar urgent care center. Because she is a TRS member, she does not need a referral. She pays the 2026 network cost-share for urgent care (roughly **$30-$50** depending on specific group status).

## Related terms * **PCM (Primary Care Manager):** The specific provider or clinic responsible for coordinating all of your medical care. * **MTF (Military Medical Treatment Facility):** A clinic or hospital operated by the Department of Defense. * **Point-of-Service (POS) Option:** An expensive cost-sharing track used when a Prime member visits a clinic without a required referral. * **Authorized Provider:** A clinic or doctor that meets TRICARE's licensing and certification requirements. * **Network Provider:** An authorized clinic that has signed an agreement with the regional contractor (Humana or TriWest) to accept lower payments.

## Sources * TRICARE.mil: Find a Doctor [https://www.tricare.mil/findaprovider] * TriWest Healthcare Alliance (West Region): [https://www.triwest.com] * Humana Military (East Region): [https://www.humanamilitary.com] * Defense Health Agency (DHA): [https://health.mil]