Does TRICARE Cover Second Opinions? | 2026 Guide | TRICARE.com

*Note: TRICARE.com is an independent reference site and is not an official government agency. For official policy and enrollment, visit TRICARE.mil.*

## Quick answer Yes, TRICARE covers second opinions for most medical procedures and diagnoses. If you are enrolled in a Prime plan, you generally need a referral from your Primary Care Manager (PCM), whereas Select and For Life users can usually seek a second opinion from any TRICARE-authorized provider without a referral.

Details

TRICARE views second opinions as a vital part of benefit coverage, particularly for surgeries or life-altering diagnoses. However, the "how" depends entirely on your specific plan and your beneficiary status.

### TRICARE Prime (Active Duty and Families) If you are an Active Duty Service Member (ADSM) or a family member enrolled in TRICARE Prime, you must coordinate a second opinion through your Primary Care Manager (PCM). * **Referral Required:** Your PCM must submit a referral request to your regional contractor (Humana Military in the East; TriWest in the West). * **Costs:** As of 2026, if you follow the referral process, there is typically no out-of-pocket cost for Prime beneficiaries. * **Point-of-Service (POS) Option:** If you seek a second opinion without a referral, you will be charged under the Point-of-Service option. For 2026, this includes a $300 deductible for individuals ($600 for families) and a 50% cost-share of the TRICARE-allowable charge.

### TRICARE Select and TRICARE For Life Beneficiaries using TRICARE Select, Reserve Select, or TRICARE For Life (TFL) have more flexibility. * **No Referral Needed:** You do not need a referral to see a second doctor, provided that doctor is a TRICARE-authorized provider. * **Costs:** You will owe the standard office visit copay or cost-share for your specific beneficiary group (Group A vs. Group B). For example, 2026 Select Group A retirees usually pay a fixed copay (roughly $38) for a specialist visit, whereas Group B (enrolled after 2018) may pay a percentage.

### Third Opinions If the second opinion disagrees with the first, TRICARE may cover a third opinion. Similar to the second, Prime members must get a referral, while Select members can proceed following standard cost-share rules.

### Important Exclusions * **Experimental Procedures:** TRICARE will not cover a second opinion for a treatment or procedure that is considered "unproven" or "experimental." * **Non-Authorized Providers:** If you see a doctor who is not TRICARE-authorized (and is not a "non-participating" provider willing to file a claim), you may be responsible for the entire bill.

## Who this affects * **Active Duty Service Members:** Required to use PCMs and military hospitals first; second opinions always require authorization. * **Active Duty Family Members:** Costs vary based on Prime vs. Select enrollment. * **Retirees and Their Families:** Can use TRICARE Select for maximum flexibility in choosing a second doctor. * **National Guard and Reserve:** Those on TRICARE Reserve Select (TRS) follow Select rules (no referral needed). * **Survivors:** Coverage depends on whether they are in a transitional Prime period or Select.

## Sources * **TRICARE.mil:** Is it Covered? (https://www.tricare.mil/CoveredServices/IsItCovered/SecondOpinions) * **Humana Military (East Region):** Referrals and Authorizations (https://www.humanamilitary.com/beneficiary/plans-and-programs/referrals-and-authorizations) * **TriWest Healthcare Alliance (West Region):** Provider Network and Authorizations (https://www.triwest.com) * **TRICARE.mil:** Cost Terms (https://www.tricare.mil/Costs/Cost-Terms)