TRICARE, decoded.

Active duty service members and their families. AD members are enrolled automatically — you don't have to sign up. Your dependents need to be enrolled through milConnect.

Free for active duty members and their families. $0 enrollment fee, $0 copays at the military treatment facility (MTF). This is the cheapest healthcare you will ever have in your life.

HMO-style managed care. You're assigned a Primary Care Manager (PCM) at your military treatment facility. All care flows through your PCM — you need a referral to see a specialist.

You must use the MTF or TRICARE network providers. Going out-of-network without a referral means you pay the full bill yourself. No exceptions, no retroactive approvals.

Your PCM must refer you to any specialist — orthopedics, dermatology, mental health (though mental health has a self-referral exception), off-post providers. This is the bottleneck everyone complains about.

If you live 50+ miles from an MTF (or the drive time exceeds 60 minutes), Prime Remote lets you use civilian providers as if they were in-network. Same $0 cost, less hassle with referrals.

Active duty families who want more provider choice, and retirees under 65. Active duty members themselves are always enrolled in Prime — Select is for dependents and retirees.

$0 enrollment fee for active duty family members. Small copays for civilian care — typically $15-$30 for outpatient visits. Still far cheaper than any civilian insurance plan.

Annual enrollment fees plus copays and cost-shares. Individual enrollment is around $170/year, family around $340/year. Still dramatically cheaper than civilian insurance.

PPO-style plan. No PCM assignment, no referrals needed. See any TRICARE-authorized provider without asking permission first. You just go.

In-network providers have agreed to TRICARE rates — lower copays, no balance billing. Out-of-network providers can charge more than the TRICARE-allowable amount, and you pay the difference.

Choose Select when: your MTF has 3-month wait times for routine care, you live near good civilian providers, your family has ongoing specialist needs, or the referral process is consistently delaying care.

Selected Reserve members and their families who are not currently on active duty orders. This includes Army Reserve, Army National Guard, Navy Reserve, Marine Corps Reserve, Air Force Reserve, Air National Guard, and Coast Guard Reserve.

Monthly premium: member-only is approximately $50/month, member-and-family is approximately $250/month. These rates are updated annually and are still dramatically cheaper than comparable civilian plans.

Functions like TRICARE Select — PPO-style, no referrals needed, see any TRICARE-authorized provider. Has copays and cost-shares similar to Select.

When activated for 30+ days, you automatically transition to TRICARE Prime (active duty) coverage. When your orders end, you go back to TRS if you re-enroll within the qualifying window.

Active duty members get free dental at the MTF dental clinic — cleanings, fillings, crowns, everything. Family members are covered through the TRICARE Dental Program administered by United Concordia, which requires a monthly premium.

Available for military retirees and their family members. Monthly premiums vary by region. Covers preventive, basic, and major dental services with annual maximums.

Limited under basic TRICARE. Annual eye exams are covered. Glasses and contact lenses are generally NOT covered for adults — only for children or if medically necessary (post-cataract surgery, keratoconus, etc.).

An enhanced primary care program at MTFs that have extra capacity. Gives you priority access for primary care at the MTF at no extra cost. Not available everywhere.

Dependent children may qualify for braces if determined to be medically necessary — meaning the condition affects function (chewing, breathing, speech), not just cosmetic appearance. Prior authorization required.

You can self-refer to mental health services. You do NOT need your commander's permission, your first sergeant's blessing, or your PCM's referral. Walk into behavioral health and ask for an appointment.

Mental health visits are generally protected by medical privacy rules. Your commander will not be notified that you sought care. Limited exceptions exist: imminent harm to self or others, fitness-for-duty evaluations, and specific security clearance inquiries.

There is no annual session limit for active duty mental health care. You get the care you need for as long as you need it. This is not like civilian insurance that caps you at 12 or 20 sessions per year.

Free, confidential non-medical counseling — up to 12 sessions per issue. Available 24/7 by phone, video, or in-person. The critical detail: these sessions are NOT in your military medical record.

Free, confidential counseling for combat veterans, veterans who experienced military sexual trauma, and their families. Operated by the VA but physically and administratively separate from VA medical centers. Staffed largely by veterans.

Transitional Assistance Management Program. 180 days of free TRICARE Prime or TRICARE Select coverage after you separate from active duty. Covers you and your family while you transition to civilian healthcare.

Continued Health Care Benefit Program. 18 to 36 months of temporary healthcare coverage you can purchase after TAMP expires. Acts as a bridge between military healthcare and civilian insurance. Premiums are higher than TRICARE but lower than COBRA.

Completely separate from TRICARE. Based on your service-connected disability rating and income. Higher disability ratings = more comprehensive coverage with lower or no copays. You must apply through VA enrollment — it's not automatic.

For military retirees with 20+ years of service who enroll in Medicare Part B at age 65. TRICARE becomes your secondary payer after Medicare. Combined coverage is extremely comprehensive with minimal out-of-pocket costs.

Civilian Health and Medical Program of the Department of Veterans Affairs. For dependents and survivors of veterans with a 100% permanent and total (P&T) disability rating. NOT TRICARE, but provides similar healthcare coverage.

$0 for all prescriptions filled at the military treatment facility pharmacy. Generics, brand-name, specialty drugs — everything is free if the MTF pharmacy has it in stock. This is the cheapest option, always.

TRICARE mail-order pharmacy through Express Scripts. $0 copay for generic medications, small copay for brand-name (around $14 for a 90-day supply of brand-name formulary drugs). Medications delivered to your door in 90-day supplies.

$14 copay for generic, $36 copay for brand-name formulary drugs at retail pharmacies (CVS, Walgreens, etc.). Only 30-day supply. This is the most expensive TRICARE pharmacy option by a wide margin.

TRICARE maintains a formulary — a list of covered medications. Formulary drugs have standard copays. Non-formulary drugs have higher copays or may not be covered at all. Some medications require prior authorization before TRICARE will pay.