An official website of the United States government
Here's how you know
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

News | Dec. 2, 2021

How to Choose Between TRICARE Prime and TRICARE Select

By TRICARE Communications

TRICARE Open Season is your yearly opportunity to review your current benefits. It’s a time to make changes to your health plan based on your personal needs. Dec. 13 marks the end of open season, so it’s important to make your decisions now. But which plan will best meet your needs in the new year?
 
“Active duty service members must enroll in TRICARE Prime,” said Elan Green, chief of TRICARE Health Plan’s Member Benefits and Reimbursement Section at the Defense Health Agency. “However, eligible active duty family members may have a choice between TRICARE Prime and TRICARE Select. You can choose the health plan that better suits your family’s needs for the coming year.”
 
To learn more about the differences between your open season health plan options, here are some key facts about TRICARE Prime and TRICARE Select.
 
What type of health plans are these?
TRICARE Prime is your managed care option, like a health maintenance organization, or HMO. It usually features the use of military hospitals and clinics. It also greatly reduces out-of-pocket costs for authorized care provided outside military facilities by TRICARE-authorized network providers.
 
TRICARE Prime is only available in certain stateside areas, called Prime Services Areas, and overseas. You can search TRICARE plans to see if TRICARE Prime is an option where you live.
 
Other TRICARE Prime options include:  
TRICARE Select is a self-managed care option, similar to a preferred provider organization, or PPO. It offers you the most freedom of choice. It’s available to most beneficiaries worldwide, including active duty family members (ADFMs), retirees, and retiree family members. In overseas locations, those who aren’t eligible to enroll in TRICARE Overseas Program (TOP) Prime, TOP Select is available.
 
How do you get care with each plan?
Under a TRICARE Prime option, you’ll get most of your routine care from a primary care manager (PCM). Your PCM could be: (1) a provider at a military hospital or clinic; (2) a civilian TRICARE network provider; or (3) a primary care provider under the US Family Health Plan. As described in the TRICARE Plans Overview, “Whether you receive care in the civilian sector or a military hospital or clinic will depend on your location and the capacity at nearby military facilities.”
 
The role of your PCM is to manage your care and refer you to specialists for care, when needed. When you need referrals or pre-authorizations, your PCM will work with your TRICARE regional contractor. If you’re an ADFM, retiree, or retiree family member, you can see a specialist without a referral under the point-of-service option. This will result in higher out-of-pocket costs.
 
With TRICARE Prime, your provider will file claims for you in most cases.
 
Under TRICARE Select, you aren’t required to have a PCM. You manage your own health care and can receive care from any provider. However, you can save money with TRICARE Select if you see a TRICARE-authorized network provider. When you receive care outside the established network of providers, you’ll have higher out-of-pocket costs.  If you choose to see a provider who isn’t an authorized TRICARE provider, TRICARE won’t reimburse you.
 
If you need specialty care, you don’t need a referral or pre-authorization in most situations. However, you may have to pay for services up front and file your own claims for reimbursement.
 
What are the costs for each plan?
In general, TRICARE Prime offers lower out-of-pocket costs than TRICARE Select. Active duty service members (ADSMs) and ADFMs pay no enrollment fees. Retirees, their families, and others pay enrollment fees.
 
If you’re an ADSM or ADFM, you won’t pay out-of-pocket costs for TRICARE covered services if you see a TRICARE network provider in your region, and with the appropriate referral or pre-authorization. Retirees pay copayments or cost-shares for covered health care services from network providers in their enrolled region. When following your plan, out-of-pocket costs are limited to your catastrophic cap. Costs you pay under the point-of-service option don’t apply toward your catastrophic cap.
 
In general, TRICARE Select has higher out-of-pocket costs than TRICARE Prime. ADFMs have no yearly enrollment fees. For retirees, their families, and others, you may have enrollment fees based on when you or your military sponsor entered the uniformed services.
 
You pay a yearly deductible and per-visit copayments or cost-shares when following the rules of your plan. Your out-of-pocket costs are limited to your catastrophic cap. Non-participating, non-network providers can charge up to 15% above the TRICARE-allowable amount. TRICARE Select beneficiaries are responsible for this amount, plus your deductible and copayments or cost-shares.
 
Want to learn more about TRICARE Prime and TRICARE Select? Take advantage of the resources available on the TRICARE website to help you decide. If you’re unsure what TRICARE plans you may be eligible for, start with Find a TRICARE Plan. You can then review the health plan costs for 2022. You can also compare costs and compare health plans. Remember, open season ends Dec. 13, so don’t wait.
Health care provider reviews a notebook

Know the Difference: TRICARE Network Provider vs...

News
Nov. 22, 2022

Are you looking for a new doctor? Finding the right doctor is crucial to your overall health. Regular checkups...
Read More
Two service members stand with two children

Keeping Your DEERS Info Current

News
Nov. 17, 2022

TRICARE Open Season is the time to make changes to your TRICARE health care coverage for the upcoming year...
Read More
Blood Donor Eligibility Update

"Mad Cow" Blood Donor Ban Lifted

News
Nov. 17, 2022

A decades-old blood donor ban was recently lifted by the Food and Drug Administrationmad cow, potentially...
Read More
Staff assigned to Naval Hospital Bremerton's OB-GYN clinic display a number of the instruments and devices associated with patient-centered care during the walk-in contraceptive clinic, an essential part of women's health services provided at NHB. The Defense Health Agency recently issued an Administrative Instruction for access to walk-in contraception services across the Military Health System, letting beneficiaries discuss and receive their preferred and medically appropriate care.

Walk-in Contraceptive Services Required at Hospi...

News
Nov. 15, 2022

The Defense Health Agency is expanding walk-in contraceptive care services to improve reproductive health...
Read More
Service member poses with her spouse

TRICARE Open Season is Here: Find Right TRICARE ...

News
Nov. 14, 2022

TRICARE Open Season begins today, Nov. 14. For most TRICARE beneficiaries, this is your chance to enroll in a...
Read More
A smiling baby

What You Should Know About RSV: Symptoms, Preven...

News
Nov. 09, 2022

You may have heard of a virus called respiratory syncytial virus, also known as RSV. TRICARE encourages you to...
Read More
Service member hugs family

Preview 2023 TRICARE Health Plan Costs

News
Nov. 07, 2022

Every year, TRICARE costs may change based on the law, the federal cost of living adjustment, changes in the...
Read More
A graphic promoting the Nov. 17 TRICARE Webinar

TRICARE to Host Open Season Webinar on November 17

News
Nov. 04, 2022

Don’t miss the “TRICARE Open Season and Your Options” webinar on Nov. 17 at 1 p.m. ET to learn more about this...
Read More

Nov. 22, 2022

Know the Difference: TRICARE Network Provider vs. Non-Network Provider

Are you looking for a new doctor? Finding the right doctor is crucial to your overall health. Regular checkups are one of the best ways to screen for diseases and prevent future health problems. When searching for a doctor, you may come across the term “network provider” or “non-network provider.” Understanding these two provider types matters to you and your family.

Nov. 17, 2022

Keeping Your DEERS Info Current

TRICARE Open Season is the time to make changes to your TRICARE health care coverage for the upcoming year. But is your information still current in the Defense Enrollment Eligibility Reporting System (DEERS)? If you’re unsure, now is a good time to check.

Nov. 17, 2022

"Mad Cow" Blood Donor Ban Lifted

A decades-old blood donor ban was recently lifted by the Food and Drug Administrationmad cow, potentially increasing the nation's blood supply by hundreds of thousands of donors each year.

Nov. 15, 2022

Walk-in Contraceptive Services Required at Hospitals and Clinics

The Defense Health Agency is expanding walk-in contraceptive care services to improve reproductive health services. These services include same-day access with no appointment or referral needed.

Nov. 14, 2022

TRICARE Open Season is Here: Find Right TRICARE Plan for You

TRICARE Open Season begins today, Nov. 14. For most TRICARE beneficiaries, this is your chance to enroll in a health plan or change health plans for coverage that starts Jan. 1, 2023. You have until Tuesday, Dec. 13, to make those changes.

Nov. 9, 2022

What You Should Know About RSV: Symptoms, Prevention, Care

You may have heard of a virus called respiratory syncytial virus, also known as RSV. TRICARE encourages you to be familiar with the signs of RSV and see your health care provider if you think you or a family member has RSV.

Nov. 7, 2022

Preview 2023 TRICARE Health Plan Costs

Every year, TRICARE costs may change based on the law, the federal cost of living adjustment, changes in the cost of health care services and prescription drugs, and other factors. Depending on your TRICARE plan, you may see changes to your costs, including enrollment fees, premiums, cost-shares, and copayments next year.

Nov. 4, 2022

TRICARE to Host Open Season Webinar on November 17

Don’t miss the “TRICARE Open Season and Your Options” webinar on Nov. 17 at 1 p.m. ET to learn more about this year’s TRICARE Open Season.

Nov. 1, 2022

Q&A: Learn About Changes to Specialty Drugs Filled in the TRICARE Pharmacy Network

Starting Jan. 1, Accredo will be the primary in-network pharmacy to fill specialty drugs in the TRICARE pharmacy network. If you’re currently filling your specialty drugs at a retail network pharmacy, you can move your specialty drugs to Accredo now to avoid disruptions to your medication therapy.

Oct. 25, 2022

Have Low Back Pain? You May Qualify for TRICARE Demonstration

There are many reasons to go to the doctor, but a very common reason is pain. Chronic pain—pain lasting three or more months—affects thousands of service members and their families every day. One such type of pain is low back pain.

Learn More about COVID-19 and the COVID-19 Vaccine.