Contents
Overview
TRICARE is the U.S. Department of Defense's health care program for service members, military retirees, and their families. It serves about 9.6 million beneficiaries worldwide. TRICARE is administered by the Defense Health Agency (DHA), an agency of the Department of Defense. Care is delivered through two channels: direct care at military hospitals and clinics (military treatment facilities, or MTFs) and purchased care from civilian providers in the TRICARE network. Two regional contractors manage purchased care in the United States: Humana Military (East Region) and TriWest Healthcare Alliance (West Region, since Jan. 1, 2025). The pharmacy benefit is managed by Express Scripts.
📋 Who It's For
Eligible groups: - Active duty service members and their families - National Guard and Reserve members (limited eligibility when not activated; full eligibility when on Title 10 orders) - Military retirees and their families (under and over age 65) - Survivors of deceased service members - Certain former spouses - Medal of Honor recipients - Adult children up to age 26 (via TRICARE Young Adult, premium-based)
Eligibility lives in the Defense Enrollment Eligibility Reporting System (DEERS) — keeping DEERS current is essential for getting care and avoiding denied claims.
💰 Costs (2025)
TRICARE is funded primarily by Congress through the Defense Health Program appropriation. Beneficiaries contribute through small enrollment fees (Prime), premiums (Reserve Select, Retired Reserve, Young Adult), deductibles, copays, and cost-shares. Active duty service members and their families pay nothing for in-network care. Retirees pay modest fees that increase modestly each year based on the National Health Expenditure Accounts index. The 2025 retiree Prime enrollment fee is $372/individual or $744/family for Group A; Group B retirees pay $450/$900.96.
🩺 What's Covered
TRICARE covers the same broad set of medically necessary services that civilian commercial health plans cover: preventive care, primary care, specialty care, hospitalization, mental health and substance use treatment, maternity care, prescription drugs (separate pharmacy benefit), durable medical equipment, hospice, and most surgeries. Plan options include:
- TRICARE Prime — managed-care HMO with a PCM
- TRICARE Select — self-managed PPO-style plan
- TRICARE For Life — automatic Medicare wraparound for retirees 65+
- TRICARE Reserve Select — premium-based for Selected Reserve members
- TRICARE Retired Reserve — premium-based for retired Reserve members under 60
- TRICARE Young Adult — premium-based for adult dependents 21–25 (or 23 if a full-time student)
- US Family Health Plan — Prime-equivalent through six designated providers in specific regions
📝 How to Enroll or Use
Step 1 — Confirm DEERS: Make sure you and your dependents are listed correctly in DEERS. Update via milConnect or your local ID card office. Step 2 — Choose a plan: Use the TRICARE Plan Finder at tricare.mil/planfinder. Active duty service members are auto-enrolled in Prime. Step 3 — Enroll: Online via milConnect, by phone with your regional contractor (Humana Military East: 800-444-5445; TriWest West: 888-TRIWEST), or by mail. Step 4 — Get your ID card: Your uniformed services ID card is your proof of TRICARE eligibility — present it at every visit. Step 5 — Use the plan: For Prime, see your PCM first; for Select, see any TRICARE-authorized provider. For pharmacy, use military pharmacies (free), home delivery via Express Scripts (lowest civilian cost), or retail network pharmacies.
⚠️ Common Pitfalls
1. Letting DEERS go stale. Wrong address, marriage, birth, divorce, or sponsor status not updated → claims get denied. 2. Confusing TRICARE.com with the official TRICARE.mil. The official program lives at tricare.mil. TRICARE.com (this site) is an independent educational guide. 3. Forgetting that retirees lose Prime/Select at 65. When you become Medicare-eligible, you transition to TRICARE For Life as wraparound on Medicare. 4. Treating the pharmacy benefit as separate insurance. Pharmacy is part of TRICARE but administered by Express Scripts and uses its own copay schedule — confirm your medication is on the formulary. 5. Missing Open Season. Plan changes outside of a Qualifying Life Event are limited to the annual TRICARE Open Season window.
❓ Frequently Asked
Is TRICARE the same as the VA? No. TRICARE is for current and retired service members and their families. The Department of Veterans Affairs (VA) provides separate health care for eligible veterans. Some people qualify for both.
What does TRICARE cost? It depends on the plan, your beneficiary group (A or B), and whether you're active duty, a family member, or a retiree. Active duty pays $0; retirees pay annual fees plus per-visit copays.
Do I need a referral? Under Prime, yes — almost always. Under Select, no — you can see any TRICARE-authorized provider directly.
Can I keep TRICARE if I leave the military? Generally no. After separation, you may qualify for the Continued Health Care Benefit Program (CHCBP), a premium-based 18–36-month transitional plan. Retirees keep TRICARE coverage for life (transitioning to TRICARE For Life at 65).
🔄 Recent Changes
Jan. 1, 2025: TriWest Healthcare Alliance took over the TRICARE West Region T-5 contract from Health Net Federal Services. The 2025 cost schedule was published in the Federal Register on Nov. 6, 2024. Jan. 1, 2018: TRICARE Standard and TRICARE Extra were merged into TRICARE Select. The Group A / Group B beneficiary distinction was created based on initial entry date. 2013: Defense Health Agency was established to manage TRICARE.
📚 Official Sources
- Official TRICARE site: https://tricare.mil
- TRICARE Plan Finder: https://tricare.mil/planfinder
- 2025 Costs and Fees Sheet: https://tricare.mil/Costs
- DEERS / milConnect: https://milconnect.dmdc.osd.mil
- East Region (Humana Military): https://www.humanamilitary.com
- West Region (TriWest): https://www.tricare-west.com
- Pharmacy (Express Scripts): https://militaryrx.express-scripts.com
Key Facts
- Category
- benefits
- Type
- topic
- Format
- guide
Frequently Asked Questions
Is TRICARE.com the official TRICARE site?
No. TRICARE.com is an independent educational guide. The official U.S. government TRICARE site is tricare.mil. Always confirm program details with the official source.
How many people use TRICARE?
Approximately 9.6 million beneficiaries worldwide, including active duty, retirees, family members, and survivors.
Who runs TRICARE?
The Defense Health Agency (DHA), an agency of the U.S. Department of Defense. Civilian care is delivered through two regional contractors: Humana Military (East) and TriWest (West, since Jan. 1, 2025).
Does TRICARE work overseas?
Yes. TRICARE Overseas is administered by International SOS and includes Prime, Select, and TRICARE For Life options for eligible beneficiaries living abroad.