TRICARE: What Veterans and Families Need to Know
TRICARE is the military health care program for active duty service members, retirees, National Guard and Reserve members, and their families. Eligibility depends on your military status and service time. TRICARE Prime offers managed care with lower costs. TRICARE Select provides more flexibility. TRICARE For Life works with Medicare for retirees 65 and older. Enrollment requires registration in DEERS.
Quick Facts
| Item | Details |
|---|---|
| Benefit | Comprehensive health coverage including medical, pharmacy, dental (separate), and vision (separate) |
| Eligibility | Active duty, retirees with 20+ years, medically retired, Selected Reserve members, certain survivors |
| Application | Enroll through milConnect (Beneficiary Web Enrollment), by phone, or by mail |
| Processing Time | Enrollment typically takes 5–10 business days; coverage effective dates vary |
| Official Agency | Defense Health Agency (DHA), U.S. Department of Defense |
| Required Forms | DD Form 2766, TRICARE Prime Enrollment Form, DEERS registration |
| Updated For | 2026 benefit year |
What Is TRICARE?
TRICARE is the Department of Defense’s health care program for uniformed services members, retirees, and their families. It is managed by the Defense Health Agency (DHA) and administered through regional contractors.
TRICARE is not the same as VA health care. VA health care serves veterans based on service-connected disabilities and income. TRICARE serves military members and retirees based on military status. Many veterans eligible for both programs can use them together, depending on the type of care needed.
TRICARE vs. VA Health Care: Key Differences
| Feature | TRICARE | VA Health Care |
|---|---|---|
| Who qualifies | Active duty, retirees, Guard/Reserve, families | Veterans with qualifying service |
| Primary agency | Defense Health Agency (DOD) | Veterans Health Administration (VA) |
| Eligibility basis | Military status and service time | Service-connected disability, income, or special eligibility |
| Enrollment required | Yes (most plans) | Yes (VA Form 10-10EZ) |
| Coverage area | Worldwide | VA facilities and authorized community care |
| Cost structure | Enrollment fees, copays, cost-shares | Copays based on disability rating and income |
TRICARE Eligibility: Who Qualifies?
TRICARE eligibility depends on your military status, service length, and in some cases, age.
Active Duty Service Members
Active duty service members are automatically enrolled in TRICARE Prime. They receive care at military hospitals and clinics (MTFs) when available. Active duty service members pay no enrollment fees and no copays for covered services when following TRICARE rules.
Active Duty Family Members
Active duty family members are eligible for TRICARE Prime or TRICARE Select. They pay no enrollment fees and have low or no copays depending on the plan.
Military Retirees
Retirees who complete 20 or more years of active service are eligible for TRICARE Prime or TRICARE Select, depending on where they live. Retirees must pay annual enrollment fees.
Veterans May Qualify for Extra Benefits
Check available financial assistance, healthcare programs and other opportunities that may apply to you.
Check EligibilityRetirees under age 65 can choose TRICARE Prime (in a Prime Service Area) or TRICARE Select. At age 65, they transition to TRICARE For Life with Medicare.
Medically Retired Service Members
Service members who separate due to a service-connected disease or disability may be eligible for both VA benefits and certain TRICARE benefits. Medically retired members with a disability rating of 30% or higher are eligible for TRICARE Prime or Select on the same terms as 20-year retirees.
National Guard and Reserve Members
Selected Reserve members and their families can purchase TRICARE Reserve Select (TRS) , a premium-based plan. TRS is available worldwide.
Guard and Reserve members who complete 20 qualifying years and receive retired pay at age 60 become eligible for standard retiree TRICARE coverage.
Survivors and Former Spouses
Surviving spouses and dependent children of deceased service members may be eligible for TRICARE. Surviving spouses have no enrollment fees for the first three years after the sponsor’s death. After three years, they pay the same fees as retirees.
TRICARE Young Adult
Dependent children who age out of regular TRICARE at age 21 (or 23 if in college) can purchase TRICARE Young Adult (TYA) until age 26.
TRICARE Plan Comparison
TRICARE offers two main health plan options: TRICARE Prime and TRICARE Select.
TRICARE Prime
TRICARE Prime is a managed-care plan available only in Prime Service Areas (PSAs) —geographic areas near military hospitals or clinics. You must choose a Primary Care Manager (PCM) who coordinates your care.
Key features:
Lower out-of-pocket costs
No annual deductible
Referrals required for most specialty care
Care coordinated through your PCM
Available in specific geographic areas
TRICARE Select
TRICARE Select is a self-managed plan available stateside and overseas. You can see any TRICARE-authorized provider without a PCM or referrals.
Key features:
More flexibility in choosing providers
Annual deductible applies
Copayments or cost-shares for services
No referrals needed for primary care and most specialty care
Available worldwide
TRICARE Prime vs. Select: 2026 Cost Comparison
| Covered Service | TRICARE Prime (Retiree) | TRICARE Select (Retiree, Network) | TRICARE Select (Retiree, Out-of-Network) |
|---|---|---|---|
| Preventive Care | $0 | $0 | $0 |
| Primary Care Visit | $26 | $38 | 25% |
| Specialty Care Visit | $39 | $52 | 25% |
| Urgent Care | $39 | $38 | 25% |
| Emergency Care | $79 | $138 | 25% |
| Annual Enrollment Fee (Individual) | $381.96 (Group A) | $186.96 (Group A) | — |
| Annual Deductible | $0 | $150–$300 | Higher |
Source: TRICARE 2026 Costs and Fees, health.mil
Which Plan Should You Choose?
| Your Situation | Recommended Plan |
|---|---|
| You want lower costs and coordinated care | TRICARE Prime |
| You want flexibility to see any provider | TRICARE Select |
| You live near a military hospital or clinic | TRICARE Prime |
| You live far from military facilities | TRICARE Select or TRICARE Prime Remote |
| You’re an active duty service member | TRICARE Prime (mandatory) |
| You’re a Selected Reserve member | TRICARE Reserve Select |
TRICARE Enrollment: How to Apply
Step 1: Register in DEERS
All TRICARE-eligible individuals must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) . Active duty service members are automatically registered. Family members must be registered by the sponsor.
To register in DEERS:
Visit a Uniformed Services ID card office with valid identification
Bring supporting documents (birth certificate, marriage certificate, adoption papers)
Receive your Uniformed Services ID card
Step 2: Choose Your Plan
Use the TRICARE Plan Finder at tricare.mil/planfinder to see available plans in your ZIP code. Compare costs, provider networks, and coverage options.
Step 3: Enroll
Online enrollment:
Log in to milConnect (milconnect.dmdc.osd.mil)
Click the “Benefits” tab
Select “Beneficiary Web Enrollment (BWE)”
Follow the prompts to enroll in your chosen plan
Phone enrollment:
Call your regional contractor (East Region: Humana Military; West Region: Health Net Federal Services).
Mail enrollment:
Complete the TRICARE Prime or Select enrollment form for your region and mail it with any required fees.
Step 4: Choose a Primary Care Manager (TRICARE Prime Only)
You may choose a military or network provider as your PCM. If you don’t choose one, TRICARE will assign one to you.
TRICARE Open Season
TRICARE Open Season runs from the second week of November to the second week of December each year. This is your annual opportunity to enroll in or change your TRICARE health plan. Outside of Open Season, you can only enroll or change plans after a Qualifying Life Event (QLE) , such as marriage, birth, adoption, or a permanent change of station (PCS).
TRICARE Costs and Fees for 2026
Group A vs. Group B
TRICARE beneficiaries are divided into two groups based on when the sponsor entered service:
Group A: Initial enlistment or appointment before January 1, 2018
Group B: Initial enlistment or appointment on or after January 1, 2018
Group B beneficiaries generally pay higher enrollment fees and cost-shares.
2026 Enrollment Fees
| Plan | Beneficiary | Group A | Group B |
|---|---|---|---|
| TRICARE Prime | Individual | $381.96/year | $462.96/year |
| TRICARE Prime | Family | $765/year | $927/year |
| TRICARE Select | Individual | $186.96/year | $594.96/year |
| TRICARE Select | Family | $375/year | $1,191/year |
Active duty family members pay $0 enrollment fees for both plans.
2026 Deductibles
| Plan | Group A | Group B |
|---|---|---|
| TRICARE Prime | $0 | $0 |
| TRICARE Select | $150 individual / $300 family | $300 individual / $600 family |
2026 Pharmacy Copayments
| Pharmacy Type | Generic Formulary | Brand-Name Formulary | Non-Formulary |
|---|---|---|---|
| Military Pharmacy (90-day) | $0 | $0 | Not available |
| Home Delivery (90-day) | $13 | $38 | $76 |
| Retail Network (30-day) | $16 | $43 | $76 |
| Non-Network Retail | Full cost upfront + claim | Full cost upfront + claim | Full cost upfront + claim |
Source: TRICARE Pharmacy Costs 2026–2027, tricare.mil
TRICARE For Life: Coverage After 65
What Is TRICARE For Life?
TRICARE For Life (TFL) is Medicare-wraparound coverage for TRICARE-eligible beneficiaries who have Medicare Part A and Part B. It acts as a secondary payer to Medicare.
TFL is available worldwide, regardless of age or place of residence. Coverage is automatic if you have Medicare Part A and Part B. You do not need to enroll in TFL separately.
Who Qualifies for TFL?
You qualify for TFL if you:
Are TRICARE-eligible (military retiree or eligible family member)
Have Medicare Part A (hospital insurance)
Have Medicare Part B (medical insurance)
Pay Medicare Part B premiums
How TFL Works with Medicare
Medicare pays first for covered services
TRICARE pays second for remaining costs
You generally pay nothing out of pocket for Medicare-covered services when using TRICARE-authorized providers
TFL and VA Facilities
If you use TFL for a non-service-connected condition at a VA facility, the VA cannot bill Medicare. TRICARE can pay only up to 20% of the TRICARE-allowable charge. For service-connected conditions, the VA provides care as a VA benefit.
Medicare Part B Enrollment
Retirees must have Medicare Part B to keep TRICARE coverage once they become eligible for Medicare. If you are eligible for premium-free Medicare Part A, you must enroll in Part B during your Initial Enrollment Period (three months before, the month of, and three months after your 65th birthday).
There is a Special Enrollment Period (SEP) for TRICARE beneficiaries that waives the Medicare Part B late enrollment penalty if you sign up during a qualifying period.
TRICARE and VA Benefits: Using Both
Can You Use TRICARE and VA Health Care Together?
Yes. Veterans who are eligible for both TRICARE and VA health care can use both programs. The VA recommends coordinated care with one treatment plan.
General rule:
Use VA health care for service-connected conditions
Use TRICARE for everything else
How Coordination Works
When you have both TRICARE and VA benefits, you choose which benefit to use for each episode of care. TRICARE will not duplicate payments made by the VA.
Example: If you see a VA provider for a service-connected knee injury, that’s a VA benefit. If you see a TRICARE network provider for a cold, that’s a TRICARE benefit.
TRICARE and Medicare at VA Facilities
| Scenario | Payer |
|---|---|
| Service-connected care at VA facility | VA benefit |
| Non-service-connected care at VA facility | VA may bill TRICARE up to 20% |
| Care at TRICARE network provider | TRICARE (with Medicare if eligible) |
| Emergency care | Medicare/TRICARE or VA (if authorized) |
TRICARE Dental and Vision Coverage
Dental Coverage
TRICARE dental coverage is separate from health coverage.
| Beneficiary | Dental Program |
|---|---|
| Active duty service members | TRICARE Active Duty Dental Program (ADDP) |
| Active duty family members | TRICARE Dental Program (TDP) |
| Retirees and their families | FEDVIP (Federal Employees Dental and Vision Insurance Program) |
| National Guard/Reserve (not on active duty) | TRICARE Dental Program (TDP) |
Retirees and their families must use FEDVIP for dental coverage. FEDVIP offers 11 dental plans and 5 vision plans. Average monthly premiums increased by 3.3% for dental and 0.5% for vision in 2026.
Vision Coverage
Vision coverage is also available through FEDVIP for retirees and their families. Active duty service members receive vision care through TRICARE Prime.
TRICARE Reserve Select
What Is TRICARE Reserve Select?
TRICARE Reserve Select (TRS) is a premium-based health plan for qualified Selected Reserve members and their families. It is available worldwide.
Who Qualifies for TRS?
You may qualify if you are:
A member of the Selected Reserve of the Ready Reserve
Not on active duty orders for more than 30 days
Not eligible for TRICARE as an active duty family member
2026 TRS Premiums
| Coverage | Monthly Premium |
|---|---|
| Member Only | $57.88 |
| Member and Family | $286.66 |
Source: MyArmyBenefits, 2026 TRICARE Reserve Select rates
How to Enroll in TRS
Verify eligibility through DEERS
Enroll through milConnect or your regional contractor
Pay monthly premiums
Coverage begins on the first day of the month after enrollment
TRICARE Appeals Process
When to File an Appeal
You can file an appeal when you disagree with a TRICARE decision about:
Coverage denial
Payment amount
Medical necessity determination
Pharmacy benefits
Types of Appeals
| Appeal Type | Deadline | Where to File |
|---|---|---|
| Factual Appeal | 90 days from EOB date | Regional contractor |
| Medical Necessity Appeal | 90 days from EOB date | Regional contractor |
| Formal Review | After initial appeal decision | TRICARE Quality Monitoring Contractor |
| Independent Hearing | 60 days from formal review decision | Defense Health Agency |
How to File an Appeal
Send a written letter to your contractor’s address
Ensure the postmark is within 90 days of the explanation of benefits
State the specific matter you disagree with
Include supporting documentation
Wait for the appeal decision
Common Mistakes with TRICARE
Not enrolling in Medicare Part B at 65: You will lose TRICARE coverage if you don’t have Part B
Missing Open Season: You can only change plans during Open Season or after a Qualifying Life Event
Not registering family members in DEERS: DEERS registration is required for TRICARE eligibility
Using non-network providers without authorization: You will pay higher costs
Not understanding Group A vs. Group B: Your enrollment fees and cost-shares depend on your group
Assuming TRICARE covers dental and vision: These are separate programs (TDP or FEDVIP)
Not filing appeals on time: Appeals must be postmarked within 90 days
Latest TRICARE Changes for 2026
Pharmacy Copayment Increases
Most TRICARE beneficiaries saw copayment increases effective January 1, 2026:
Generic formulary drugs: $13 → $14 (home delivery)
Brand-name formulary drugs: $43 → $48 (retail)
Non-formulary drugs: $76 → $85
TRICARE Prime Remote Pharmacy Waiver
Effective February 28, 2026, TRICARE Prime Remote enrollees in the U.S. have no copayments for covered prescriptions at retail network pharmacies and TRICARE Pharmacy Home Delivery.
TENS Coverage Change
Effective July 1, 2026, TRICARE no longer covers TENS devices for any conditions except acute post-operative pain.
Weight Loss Drug Coverage
As of August 31, 2025, TRICARE pharmacy benefit does not cover weight loss drugs for TFL beneficiaries when obesity is the primary diagnosis. Beginning July 1, 2026, Medicare Part D covers certain weight loss drugs under the Medicare GLP-1 Bridge Program.
2026 Cost-of-Living Adjustment
The CY 2026 retiree COLA increase is 2.8% , affecting TRICARE enrollment fees and cost-shares.
Common Questions
1. What is TRICARE and who qualifies?
TRICARE is the military health care program for active duty service members, retirees, National Guard and Reserve members, and their families. Eligibility depends on military status and service time. Active duty members are automatically enrolled. Retirees need 20+ years of service. Guard/Reserve members can purchase TRICARE Reserve Select.
2. What’s the difference between TRICARE Prime and TRICARE Select?
TRICARE Prime is a managed-care plan with a Primary Care Manager, lower costs, and referrals for specialty care. It’s only available in Prime Service Areas. TRICARE Select is a self-managed plan with more flexibility, higher costs, and no referrals needed for most care. It’s available worldwide.
3. How much does TRICARE cost in 2026?
TRICARE Prime enrollment fees for retirees are $381.96/year (Group A) or $462.96/year (Group B) for individuals. TRICARE Select fees are $186.96–$594.96/year for individuals. Copays range from $0 for preventive care to $79+ for emergency visits. Pharmacy copays range from $0 (military pharmacy) to $85 (non-formulary).
4. How do I enroll in TRICARE?
Register in DEERS first, then enroll through milConnect (Beneficiary Web Enrollment), by phone with your regional contractor, or by mail. TRICARE Open Season runs from the second week of November to the second week of December. Outside Open Season, you need a Qualifying Life Event.
5. What is TRICARE For Life?
TRICARE For Life is Medicare-wraparound coverage for TRICARE-eligible beneficiaries who have Medicare Part A and Part B. It acts as a secondary payer to Medicare. Coverage is automatic and available worldwide. You must pay Medicare Part B premiums to maintain TFL.
6. Do I need Medicare Part B to keep TRICARE?
Yes. If you are a military retiree and eligible for Medicare Part A, you must enroll in Medicare Part B to keep your TRICARE coverage. This applies at age 65 or when you become eligible due to disability. A Special Enrollment Period waives the Part B late enrollment penalty for TRICARE beneficiaries.
7. Can I use TRICARE and VA health care together?
Yes. Veterans eligible for both can use TRICARE and VA health care. The general rule is to use VA for service-connected conditions and TRICARE for everything else. TRICARE will not duplicate payments made by the VA. Coordinate care with your providers.
8. What is TRICARE Reserve Select?
TRICARE Reserve Select is a premium-based health plan for Selected Reserve members and their families. It is available worldwide. 2026 monthly premiums are $57.88 for member-only coverage and $286.66 for member and family coverage. You must not be on active duty orders for more than 30 days.
9. Does TRICARE cover dental and vision?
TRICARE health plans do not include routine dental and vision coverage. Active duty members receive dental through the Active Duty Dental Program. Retirees and families use FEDVIP for dental and vision. Guard/Reserve members can purchase the TRICARE Dental Program.
10. How do I file a TRICARE appeal?
Send a written letter to your regional contractor within 90 days of the explanation of benefits date. State the specific matter you disagree with and include supporting documentation. You can file factual appeals, medical necessity appeals, formal reviews, and independent hearings depending on the issue.
Key Takeaways
TRICARE is the military health program for active duty, retirees, Guard/Reserve, and families. It is separate from VA health care but can be used together.
TRICARE Prime offers managed care with lower costs and a Primary Care Manager. TRICARE Select offers flexibility with higher costs and no referrals.
2026 enrollment fees for retirees range from $186.96 to $594.96/year for individuals, depending on plan and group.
TRICARE For Life is Medicare-wraparound coverage for retirees 65+ with Medicare Part A and Part B.
Medicare Part B enrollment is mandatory to keep TRICARE coverage once you become eligible for Medicare.
TRICARE Reserve Select is available to Selected Reserve members for $57.88–$286.66/month in 2026.
Dental and vision are separate programs: TDP for active duty families and Guard/Reserve, FEDVIP for retirees.
Pharmacy copays increased in 2026 for most beneficiaries. Military pharmacy remains $0 for formulary drugs.
Appeals must be filed within 90 days of the explanation of benefits date.
Register in DEERS first to establish TRICARE eligibility.
Official Resources
TRICARE Official Website: https://tricare.mil
TRICARE Plan Finder: https://tricare.mil/Plans/PlanFinder
TRICARE Costs: https://tricare.mil/costs
TRICARE For Life: https://tricare.mil/Plans/HealthPlans/TFL
TRICARE Pharmacy: https://tricare.mil/pharmacy
TRICARE Reserve Select: https://tricare.mil/Plans/HealthPlans/TRS
TRICARE Enrollment: https://tricare.mil/Plans/Enroll
milConnect (Beneficiary Web Enrollment): https://milconnect.dmdc.osd.mil
DEERS Registration: https://www.cac.mil/DEERS
TRICARE Appeals: https://tricare.mil/Claims/Appeals
FEDVIP (Dental and Vision): https://www.opm.gov/healthcare-insurance/dental-vision/
VA Health Care: https://www.va.gov/health-care/
Medicare: https://www.medicare.gov
MyArmyBenefits (TRICARE Resources): https://myarmybenefits.us.army.mil
Military OneSource: https://www.militaryonesource.mil
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