TRICARE, in plain English.

The five major plans

• TRICARE Prime — HMO-style. Active duty MUST be on Prime; family members and retirees can opt in. Lowest cost, requires referrals through PCM.
• TRICARE Select — PPO-style. See any TRICARE-authorized provider, no referrals. Higher costs but flexibility.
• TRICARE for Life (TFL) — for Medicare-eligible retirees and dependents. Wraps around Medicare; you must enroll in Medicare Part A and B.
• TRICARE Reserve Select (TRS) — for Selected Reserve members not on active orders. Premium-based, like a marketplace plan.
• TRICARE Retired Reserve (TRR) — for "gray area" retired Reservists not yet eligible for retired pay (under 60).

Coverage at separation

Active duty separating without retirement: TRICARE ends within months of your last day. Two bridge options:

• Transitional Assistance Management Program (TAMP) — 180 days of Prime/Select coverage at no cost for involuntary or stop-loss separations
• Continued Health Care Benefit Program (CHCBP) — 18-36 months of TRICARE-like coverage. Buy within 60 days of separation. Premiums apply.

Retirees keep TRICARE for life — Prime/Select before 65, TFL after.

Big life events that change your TRICARE

• PCS: Update DEERS within 30 days. Prime enrollees may need to re-enroll regionally.
• Marriage: Add spouse in DEERS within 90 days for retroactive coverage.
• New child: Add to DEERS within 90 days for retroactive coverage; enroll in Prime/Select if you want primary care assigned.
• Divorce: Former spouse may keep TRICARE under 20/20/20 or 20/20/15 rules; otherwise CHCBP.
• Retirement: Re-enroll within 90 days to avoid lapse.
• Aging out at 26 (kids): Children lose TRICARE; may purchase TRICARE Young Adult through age 26.

Mental health under TRICARE

• Same coverage as physical care
• No mental health visit limits as of 2017
• Telehealth covered for therapy
• Marriage counseling, family therapy, and substance use covered

Pharmacy

• Military pharmacy: zero copay for formulary drugs
• TRICARE Mail Order: low cost for 90-day supplies
• Network retail pharmacy: small copay (varies by drug tier)
• Non-network: highest cost; usually avoid

Out-of-pocket costs by plan (2025 sample)

Costs change yearly; check TRICARE.mil for current numbers. Active duty pay nothing. Retirees and family members have:

• Prime: $0–$25 copays for most visits, low annual catastrophic cap
• Select: deductible + cost-share, no referrals
• TFL: covers what Medicare doesn't; you pay Medicare premiums and TFL is free
• TRS: monthly premium; competitive with marketplace plans

Common mistakes

• Not updating DEERS after a life event — coverage interrupted
• Missing the 60-day CHCBP window after separation
• Not enrolling in Medicare Part B at 65 — you'll lose TFL eligibility
• Out-of-pocket purchase of branded drugs at network retail when MOP would cost less

If TRICARE denies a service

You can appeal at three levels: reconsideration by the regional contractor, formal review, and finally the TRICARE National Quality Monitoring Contractor. Your written denial letter tells you which level applies.

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