TRICARE Prime vs. Select: Which Plan Is Right for You?
TRICARE Prime is a managed care option similar to an HMO, requiring a primary care manager (PCM) and referrals for specialty care. TRICARE Select is a preferred provider option similar to a PPO, offering more freedom to choose providers without referrals. Both are available to active duty family members, retirees, and their families, but they differ significantly in cost structure and flexibility.
Eligibility
TRICARE Prime
Active duty service members (auto-enrolled), ADFMs, retirees under 65, and their families. Must live within a Prime Service Area.
TRICARE Select
ADFMs, retirees under 65, and their families. Available nationwide with no geographic restrictions.
Feature Comparison
| Feature | TRICARE Prime | TRICARE Select |
|---|---|---|
| Provider Choice | Must use assigned PCM; referrals needed for specialists | Choose any TRICARE-authorized provider; no referrals needed |
| Primary Care Manager | Required — assigned at enrollment | Not required — see any provider |
| Referrals Required | Yes, for specialty care | No referrals needed |
| Network Requirement | Must use network providers | Can use network or non-network providers |
| Point-of-Service Option | Available with higher cost share | Built into plan design |
| Appointment Availability | Guaranteed access standards | Subject to provider availability |
| Preventive Care | Covered at no cost | Covered at no cost (network) |
| Emergency Care | Covered worldwide | Covered worldwide |
Cost Comparison
| Cost | TRICARE Prime | TRICARE Select |
|---|---|---|
| Annual Enrollment Fee (E1-E4) | $0 | $0 |
| Annual Enrollment Fee (E5+/O1-O10) | $0 | $0 |
| Annual Enrollment Fee (Retirees) | $388.32/individual, $776.64/family | $170/individual, $340/family |
| Primary Care Visit (ADFMs) | $0 | $0 network / $0 non-network + 20% cost share |
| Specialist Visit (ADFMs) | $0 with referral | $28 network / deductible + 25% non-network |
| ER Visit (ADFMs) | $0 | $40 network |
| Annual Deductible (ADFMs) | $0 | $150/individual, $300/family |
| Catastrophic Cap | $1,000 | $1,000 |
Pros & Cons
TRICARE Prime
Pros
- Lower out-of-pocket costs, especially for families with frequent care needs
- No enrollment fees for active duty families
- Guaranteed appointment access standards
- Predictable costs with $0 copays for most services
- Includes travel reimbursement if driven to distant providers
Cons
- Must use assigned PCM — less provider flexibility
- Referrals required for all specialty care
- Must live within a Prime Service Area
- Harder to see out-of-network specialists
- Higher costs if using Point-of-Service option
TRICARE Select
Pros
- Freedom to choose any TRICARE-authorized provider
- No referrals needed for specialty care
- Available nationwide — no geographic restrictions
- Easier to continue seeing existing civilian providers
- Good option for families who PCS frequently
Cons
- Higher out-of-pocket costs for most services
- Annual deductibles apply
- No guaranteed appointment access standards
- Non-network care costs significantly more
- Higher enrollment fees for retirees
Best For
TRICARE Prime
Families who want the lowest costs and don't mind using a PCM with referrals. Best for those living near military treatment facilities who prioritize affordability.
TRICARE Select
Families who value flexibility and want to choose their own doctors. Best for those living far from military bases or who PCS frequently.