Healthcare (TRICARE)

TRICARE, the Department of Defense health program managed by the Defense Health Agency, covers about 9.5 million service members, retirees, and family members worldwide. For you, it starts the moment you ship. For your family, it starts when you register them in DEERS.

Prime for active duty: a PCM, referrals, and a zero-dollar bill

You'll be automatically enrolled in TRICARE Prime on active duty. It works like a civilian HMO: one designated provider coordinates everything you need.

That provider is your Primary Care Manager (PCM), typically located at the Military Treatment Facility (MTF), the military hospital or clinic on or near your installation, where active duty members get priority access. Your PCM handles routine care and refers you to specialists. Skip picking one during enrollment and TRICARE assigns one for you; if no military provider slots are open at your duty station, you're assigned a civilian network provider instead. You can change PCMs at any time through milConnect (the online benefits portal), by phone with your regional contractor, or by submitting a change form.

Specialty care requires a referral. Your PCM submits the request to your regional contractor, approval typically takes 2 to 5 business days, and the authorization names the approved provider, the covered services, and an expiration date. Two things never need a referral: emergency care and preventive services like annual checkups.

Here's the mistake that costs people real money: booking a specialist without the referral. That triggers the "point-of-service option," which means significant out-of-pocket costs for care that would otherwise be free.

The price for all of it: zero. No enrollment fees, no copayments, no deductibles, no cost-shares, as long as care flows through your PCM or a proper referral.

Your family picks: Prime's structure or Select's freedom

Family members can choose Prime or TRICARE Select, a self-managed plan that works like a civilian PPO.

What Select costs depends on your group. Beneficiaries whose sponsor entered service before January 1, 2018, are Group A and generally pay less. Everyone enlisting today is Group B and pays somewhat more. Both groups pay annual deductibles (what you pay before TRICARE starts sharing costs), copays for office visits, and cost-shares (a percentage of the bill) for procedures, all cheaper with network providers. The catastrophic cap is the safety net: for 2026, Group B active duty families pay at most about $1,324 out of pocket for the year, and TRICARE covers 100% of costs past that threshold.

Enrollment happens in one of two windows: TRICARE Open Season (typically November 10 through December 9, with changes effective January 1) or within 90 days of a Qualifying Life Event such as marriage, the birth of a child, or a PCS move.

And be clear about who the free ride covers: only the active duty member. Family plans carry the costs above, and retirees pay annual enrollment fees running from $186 to over $1,191.

Coverage facts that surprise people

• Pre-existing conditions are covered with no restrictions, including prenatal care for a spouse who is already pregnant when she becomes eligible.
• Mental health coverage is comprehensive: individual, group, and family therapy, psychiatric care, substance use disorder treatment, and telehealth. The gap people hit: marriage counseling is not covered.
• There is no TRICARE insurance card. A military dependent ID plus DEERS registration is all a provider needs.
• Emergency care is covered everywhere, no referral, regardless of location.

Guard and Reserve: you buy in, and it's cheap

In drilling status (monthly training weekends and annual training, not active duty orders), you can purchase TRICARE Reserve Select (TRS), a premium-based plan that behaves like Select: no assigned PCM, no referrals for most services. For 2026, premiums run about $57.88 a month for member-only coverage or $286.66 for a family. Those rates are set by Congress, and they're a steep discount: Kaiser Family Foundation data puts the average civilian employee's share of family coverage near $550 a month.

The fine print that matters:

• Eligibility: you must be in the Selected Reserve (drilling Guard and Reserve units), not on active duty orders over 30 days, not covered under TAMP (the transitional program described below), and not eligible for Federal Employees Health Benefits. Congress has mandated that federal employees become TRS-eligible on January 1, 2030.
• No open season: enroll any time you're eligible. But voluntarily disenroll and you face a 12-month lockout before you can come back.
• Cost-sharing follows Group B rates no matter when you joined.
• MTF access is space-available, not priority.

Guard versus Reserve changes nothing here. The two differ in administrative assignment and state versus federal authority; the healthcare options and premiums are identical.

Activation for more than 30 days flips you to active duty coverage automatically: TRICARE Prime at no cost, priority MTF access, and automatic enrollment in active duty dental. Your family can enroll in Prime or Select within 90 days of the activation date, and after deactivation, transitional coverage continues for 180 days. The full plan detail, including TRS deductibles and copays, lives in Guard and Reserve Specific Benefits.

Dental is a separate system. Don't assume you're covered.

Your TRICARE medical plan includes zero dental. Three distinct programs handle it, by status:

ADDP, administered by United Concordia, runs through the military dental clinic on your installation, with civilian dental care available when the military clinic refers you or when you're stationed more than 50 miles from a military facility. No forms required. The limitation worth knowing up front: orthodontics (braces) are generally not covered for active duty members.

TDP carries a 12-month minimum enrollment commitment, and Guard/Reserve members enroll and pay separately from their families. Coverage varies by service: diagnostic and preventive care is typically covered at 100%, fillings and major restorative work (crowns, bridges) carry cost-shares, and orthodontics come with waiting periods and lifetime maximums. Premiums change on a March-to-February cycle rather than the calendar year; current rates are at tricare.mil/Costs/DentalCosts/TDP.

FEDVIP, the Federal Employees Dental and Vision Insurance Program, replaced the TRICARE Retiree Dental Program in 2019. Retirees choose among multiple insurance carriers and enroll at BENEFEDS.com during the annual Federal Benefits Open Season, typically November 10 through December 8.

What changed in 2025 and 2026

The regional map was redrawn. Effective January 1, 2025, six states (Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin) moved from the East Region to the West Region, which means TriWest Healthcare Alliance (888-TRIWEST) instead of Humana Military (800-444-5445). The new T-5 contracts brought more efficient referral transfers between regions and better access to specialized care, but the transition itself caused claims processing delays and provider network problems into early 2025. Overseas, the TRICARE Overseas Program provides coverage through International SOS, primarily at military facilities with civilian options available. Each region runs its own networks and processes; TRICARE does not work the same everywhere.

Pharmacy copays rose in January 2026:

Military pharmacies remain free for all covered medications.

Prime Remote families gained $0 pharmacy copays. Effective February 28, 2026, active duty family members enrolled in TRICARE Prime Remote in the United States pay nothing for covered prescriptions at retail network pharmacies or through home delivery, matching the benefit their sponsors already had. Authorized by the FY2025 NDAA, applied automatically with no re-enrollment, reaching roughly 58,000 family members. It does not extend to families stationed overseas.

Weight loss drug coverage split. As of August 31, 2025, TRICARE For Life (the plan for Medicare-eligible retirees) no longer covers GLP-1 weight loss medications like Wegovy and Zepbound. Prime and Select beneficiaries keep coverage when a network provider prescribes with prior authorization and a comprehensive treatment plan, and the prescriptions can only be filled at civilian network pharmacies, never military ones.

Contraceptive cost-sharing ended. The FY 2025 National Defense Authorization Act eliminated cost-sharing for all TRICARE-covered contraceptives under the pharmacy benefit.

Coverage follows you from ship day to separation

At BMT and technical school, you're covered from the moment you ship out. All care comes through military treatment facilities, with no paperwork to file and no providers to choose. That coverage is effective for up to 180 days; formal enrollment and PCM assignment happen during in-processing at your first duty station.

Your family's access starts with DEERS, the Defense Enrollment Eligibility Reporting System, the database that verifies TRICARE eligibility. Before you leave: gather marriage certificates, birth certificates, and Social Security cards, and register your dependents through your service personnel office. They should get military ID cards as soon as possible after you depart, and they can enroll in TRICARE the moment you ship. New dependents must be added within 90 days of a marriage, birth, or adoption (120 days if overseas). The step-by-step is in Getting Married.

During deployments, nothing changes on paper. Military medical personnel treat you in theater, your family's coverage continues uninterrupted at home, and if they move mid-deployment they can transfer enrollment to the new regional contractor.

After separation, the Transitional Assistance Management Program (TAMP) provides 180 days of premium-free coverage for qualifying separations: involuntary separation under honorable conditions, Guard/Reserve members separating after contingency operations support, and separations following stop-loss retention. When TAMP ends, the Continued Health Care Benefit Program (CHCBP) offers 18 to 36 months of premium-based coverage as a bridge to civilian insurance. Deadlines and premiums are in Planning Your Transition.

Every number here has an expiration date

TRICARE runs on federal law and annual adjustments; the 2026 cycle alone raised costs 2 to 7% across categories. Before making decisions, verify: