Compare TRICARE Plans: Prime vs. Select vs. TRS | TRICARE.com

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## Quick answer Comparing TRICARE plans primarily involves choosing between the HMO-style **TRICARE Prime** (managed care with a primary doctor) and the PPO-style **TRICARE Select** (flexible provider choice with higher out-of-pocket costs). Active duty members are required to use Prime, while retirees and families must decide based on their budget, location, and preferred level of access to civilian specialists.

## In detail Choosing the right TRICARE plan depends on your beneficiary status (Active Duty vs. Retiree) and your "Group" status (Group A if enlisted/commissioned before Jan. 1, 2018; Group B if after).

### TRICARE Prime vs. TRICARE Select These are the two flagship programs for stateside beneficiaries.

* **TRICARE Prime:** Operates like an HMO. You are assigned a Primary Care Manager (PCM) at a Military Medical Treatment Facility (MTF) or a civilian network provider. You need referrals for all specialty care. * **Cost:** No enrollment fees for active duty; modest annual fees for retirees. No out-of-pocket costs for clinical preventive services. * **Pros:** Lowest out-of-pocket costs; simplified billing. * **Cons:** Limited choice of doctors; referral requirements. * **TRICARE Select:** Operates like a PPO. You do not need a PCM and can see any TRICARE-authorized provider without a referral. * **Cost:** No enrollment fees for active duty families, but annual deductibles and copayments apply. Retirees pay monthly enrollment fees and higher cost-shares. * **Pros:** Maximum flexibility; no referrals needed for most services. * **Cons:** Higher out-of-pocket costs; you may have to file your own claims with non-network providers.

### 2026 Plan Comparison Table (Group A Retirees) *Note: 2026 rates are subject to annual adjustments by the Defense Health Agency.*

| Feature | TRICARE Prime (Retirees) | TRICARE Select (Retirees) | | :--- | :--- | :--- | | **Annual Enrollment Fee** | ~$390 (Individual) / ~$780 (Family) | ~$190 (Individual) / ~$380 (Family) | | **Annual Deductible** | None | $150 (Individual) / $300 (Family) | | **Primary Care Visit** | ~$25 copay | ~$35-$40 copay | | **Specialty Care Visit** | ~$35-$40 copay (Referral Req) | ~$50-$60 copay (No Referral) | | **ER Visit** | ~$75 copay | ~$140-$160 copay | | **Catastrophic Cap** | $3,000 | $4,000 |

### Premium-Based Plans If you do not qualify for Prime or Select (e.g., National Guard/Reserve or young adults), you must compare premium-based options: * **TRICARE Reserve Select (TRS):** For qualified Selected Reserve members. Offers Select-like coverage. * **TRICARE Retired Reserve (TRR):** For gray-area retirees under age 60. Significantly higher monthly premiums. * **TRICARE Young Adult (TYA):** For adult children up to age 26 who are not otherwise eligible for employer-sponsored insurance. Available in Prime and Select versions.

## Who this applies to * **Active Duty Service Members (ADSMs):** Comparison is rarely needed; Prime is mandatory. * **Active Duty Family Members (ADFMs):** Must choose between Prime (lower cost) or Select (more flexibility). * **Retirees and their Families:** Must choose between Prime or Select and account for annual enrollment fees. * **National Guard and Reserve:** Must compare TRS against their civilian employer-sponsored health plans.

Common scenarios

### Scenario 1: The Specialist Seeker Sarah is an active duty spouse (Group A) with a chronic condition requiring a specific civilian neurologist. Under **TRICARE Prime**, she would need a referral and might be directed to an MTF. Under **TRICARE Select** in 2026, she pays $0 enrollment fees, a $150 deductible, and a $35-50 copay per visit, but she can see any network neurologist immediately without a referral.

### Scenario 2: The Budget-Conscious Retiree Mark is a retired veteran (Group A) living near a military base. He chooses **TRICARE Prime**. In 2026, he pays roughly $390 per year in enrollment fees. Because he uses his PCM for everything, his out-of-pocket costs are capped at approximately $3,000 for the year, and he has no deductible to meet.

### Scenario 3: The Young Adult transition James is 23, the son of a retired Soldier, and just graduated college. He is not yet employed. He compares **TYA Prime** vs. **TYA Select**. TYA Prime requires a PCM and referrals, while TYA Select lets him choose his doctors. Both require high monthly premiums (often exceeding $300-$600/month depending on the year's T-5 contract adjustments).

## Related terms * **Catastrophic Cap:** The maximum amount you pay out-of-pocket for covered services each calendar year. * **Cost-Share:** The percentage of the total cost of a covered health care service you pay (typically associated with Select). * **Point-of-Service (POS) Option:** An expensive feature of Prime that allows you to see non-PCM providers without a referral. * **Network Provider:** A civilian provider that has a contract with Humana Military (East) or TriWest (West). * **Referral:** A request from your PCM for you to see a specialist, required for all Prime users.

## Sources * TRICARE Plan Finder: https://www.tricare.mil/Plans/PlanFinder * TRICARE Costs: https://www.tricare.mil/Costs * Humana Military (East Region): https://www.humanamilitary.com/ * TriWest Healthcare Alliance (West Region): https://www.triwest.com/