What is TRICARE?

TRICARE is the health care program managed by the Defense Health Agency (DHA). Similar to a commercial health insurance program, TRICARE provides comprehensive health care coverage to its beneficiaries including preventative care, primary care, specialist care, hospitalization, and prescription drugs.

TRICARE beneficiaries include:

• Active-duty service members (Army, Navy, Air Force, Marine Corps, Coast Guard, Public Health Commission Corps, and National Oceanic and Atmospheric Administration Corps) and their families

• National Guard/Reserve members and their families

• Retired service members and their families

• Retired Reserve members and their families

• Survivors

• Former spouses

• Medal of Honor recipients and their families

• Dependent parents and parents-in-law

• Foreign Force members and their families

TRICARE is not a single, overarching model of care. Instead, TRICARE is the collective name of a program that offers a combination of different health care delivery plans. There are over eight core TRICARE plan options, each having its own set of benefits and costs. While plan model availability is dependent on a variety of factors, there are four primary TRICARE plans most enrollees are using.

• TRICARE Prime requires the selection of a primary care physician (PCP) and the use of a specific network of providers and hospitals. It tends to focus and emphasize preventative care, which can result in lower out-of-pocket costs for in-network, covered services. For active-duty service members, enrollment is automatic in TRICARE Prime and the individual can only decline enrollment for specific reasons. TRICARE Prime is the TRICARE plan most similar to a commercial Health Maintenance Organization (HMO) plan.  

• TRICARE Select is a point-of-service plan that allows flexibility in selection of providers and hospitals. Enrollees may choose to visit both in-network and out-of-network providers, with in-network providers generally resulting in lower costs. TRICARE Select is the TRICARE plan most similar to a commercial Preferred Provider Organization (PPO) plan.

• TRICARE Standard is a fee-for-service (or indemnity) plan that pays a portion of the cost regardless of whether the provider is in-network or out-of-network, civilian or military. It does not require a referral to see a specialist. There is not an exact commercial mirror to TRICARE Standard; however, it is most similar to a commercial High-Deductible Health Plan (HDHP) with a Health Savings Account (HSA).

• TRICARE For Life is limited to Uniformed Service retirees entitled to Medicare Part A and enrolled in Medicare Part B and their spouses. Unlike other TRICARE plans, it is not available to other family members. Once enrolled in Medicare Part A and Part B, a beneficiary is also automatically and seamlessly enrolled in TRICARE for Life. While not a direct comparison, TRICARE For Life is most similar to commercial Medicare supplement plans.

By offering a variety of health care plan models, individuals and families can choose the TRICARE plan that best aligns with their healthcare priorities.

How do Military Treatment Facilities (MTFs) fit into TRICARE?

MTFs are the core health care locations for individuals enrolled in TRICARE and provide direct primary care, specialty care, hospitalization, and other healthcare services. MTFs are in-network providers for the TRICARE Prime and Select networks.