TRICARE Prime vs Select: 2026 Costs & Comparison
*CRITICAL NOTE: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense or the official TRICARE program. For official policy and the most current data, visit [TRICARE.mil](https://www.tricare.mil).*
## Quick answer **TRICARE Prime** is an HMO-style plan with a assigned primary care manager and low out-of-pocket costs, but it requires referrals for specialists. **TRICARE Select** is a PPO-style plan offering more flexibility to choose your own doctors without referrals, but it carries higher out-of-pocket costs like deductibles and copays.
Details
### 1. Structure and Management * **TRICARE Prime:** Operates like a Health Maintenance Organization (HMO). Most care is provided at a Military Medical Treatment Facility (MTF). You are assigned a Primary Care Manager (PCM) who coordinates all your care. If you need a specialist, you **must** get a referral from your PCM. * **TRICARE Select:** Operates like a Preferred Provider Organization (PPO). You can see any TRICARE-authorized provider (Network or Non-Network) without a referral. You manage your own specialty care, though some services (like surgery or home health) may still require "prior authorization."
### 2. Costs and Fees (2026 Rates) Costs vary depending on the sponsor’s "Group" status (Group A joined before Jan 1, 2018; Group B joined on or after).
* **Enrollment Fees:** * **Prime:** Active Duty families pay $0. Retirees pay an annual enrollment fee (roughly $390+ for individuals or $780+ for families in 2026—check TRICARE.mil for exact tiered rates). * **Select:** Active Duty families pay $0. Retirees pay an annual enrollment fee (roughly $190+ for individuals or $380+ for families in 2026). * **Deductibles:** * **Prime:** No deductible for care within the network/PCM. * **Select:** Requires meeting an annual outpatient deductible (varies from $60 to $375+ based on rank and Group status) before the plan begins paying. * **Copayments:** * **Prime:** Generally $0 for active duty families; small fixed copays for retirees. * **Select:** Fixed copays for network providers; 20–25% cost-shares for non-network providers.
### 3. Point-of-Service (POS) Option A major pitfall of **TRICARE Prime** is the Point-of-Service option. If you see a specialist without a referral, TRICARE will not deny the claim, but they will process it under POS charges. This results in a **$300 deductible** and a **50% cost-share**, which does not count toward your annual catastrophic cap. **TRICARE Select** does not have this penalty because referrals are not required.
### 4. Regional Contractors (The T-5 Contract) As of 2026, your plan is administered by: * **East Region:** Humana Military. * **West Region:** TriWest Healthcare Alliance. * **Pharmacy:** Express Scripts.
## Who this affects * **Active Duty Service Members:** MUST enroll in Prime (or Prime Remote); Select is not an option. * **Active Duty Family Members:** Can choose between Prime and Select. * **Retirees & Families:** Can choose between Prime and Select (until age 65/Medicare eligibility). * **National Guard & Reserve:** Generally use TRICARE Reserve Select (TRS), which functions similarly to the Select model. * **Survivors:** Eligible for both Prime and Select depending on status.
## Sources * **TRICARE.mil:** [Plan Comparison Tool](https://www.tricare.mil/Plans/ComparePlans) * **Humana Military (East):** [Provider Directory and Costs](https://www.humanamilitary.com/) * **TriWest Healthcare Alliance (West):** [Plan Information](https://www.triwest.com/) * **Express Scripts:** [Pharmacy Benefits](https://www.express-scripts.com/tricare)