HomeNewsDisplay

News Search

Which plan is right for you? Comparing TRICARE Prime and TRICARE Select

TRICARE Open Season and Federal Benefits Open Season are underway. You now have until Dec. 10, 2018 to enroll in a new plan or change your enrollment between plans. The choice you make will take effect Jan. 1, 2019 and will remain in effect through all of 2019. (TRICARE Communications graphic)

TRICARE Open Season and Federal Benefits Open Season are underway. You now have until Dec. 10, 2018 to enroll in a new plan or change your enrollment between plans. The choice you make will take effect Jan. 1, 2019 and will remain in effect through all of 2019. (TRICARE Communications graphic)

FALLS CHURCH, Va. -- If you have health coverage with TRICARE, you can choose from a variety of plans, which provide you options in where and how you seek medical and dental services. Two major health programs include TRICARE Prime and TRICARE Select. Both require enrollment and each offer the quality care you deserve. Learn more about the available plans, so you can choose the program or programs that are best for you and your family members.

TRICARE Prime

TRICARE Prime is a managed care option and a health maintenance organization (HMO)-like program. It generally features the use of military hospitals and clinics and reduces out-of-pocket costs for authorized care provided outside military hospitals and clinics by TRICARE network providers. TRICARE Prime is mandatory for active duty service members (ADSMs) and is an option for their family members and certain TRICARE-eligible beneficiaries located in Prime Service Areas (PSAs) in the U.S.

In geographical areas where TRICARE Prime is not offered, TRICARE Prime Remote for Active Duty Family Members may be available as an enrollment option for eligible active duty family members (ADFMs). In overseas locations, TRICARE Overseas Program (TOP) Prime and TOP Prime Remote are available to ADSMs and their command-sponsored family members.

The US Family Health Plan (USFHP) is an additional TRICARE Prime option available through networks of community-based, not-for-profit health care systems in six areas of the U.S. To enroll in USFHP, you must live in one of the designated service areas.

Under a TRICARE Prime option, your health care is managed by an assigned primary care manager (PCM) and provided by a military or civilian network provider. Non-active duty enrolled beneficiaries will select or be assigned a PCM. TRICARE Prime PCMs may be:

  • At a military hospital or clinic
  • A civilian TRICARE network provider within a PSA
  • A primary care provider in the USFHP, depending on your location and sponsor status

Whether you receive care in the civilian sector or at a military hospital or clinic will depend on your location and the capacity at nearby military facilities.

TRICARE Select

On Jan. 1, 2018, TRICARE Select replaced TRICARE Standard and TRICARE Extra. TRICARE Select is a self-managed, preferred-provider option for eligible beneficiaries (except ADSMs and TRICARE For Life beneficiaries) not enrolled in TRICARE Prime. TRICARE Select allows you to choose your own TRICARE-authorized provider and manage your own health care.

Beneficiaries may receive enhanced TRICARE Select benefits from any TRICARE-authorized provider without a referral. You’ll have lower out-of-pocket costs if care is provided by a TRICARE-authorized network provider. Some services require prior authorization. You can also receive certain services from non-network, TRICARE-authorized providers, but will pay higher cost sharing amounts for out-of-network care. TRICARE won’t reimburse you for care received from non-authorized, non-network providers.

Under a TRICARE Select option, you pay a fixed fee for care for most services from a TRICARE network provider instead of paying a percentage of the allowable charge. As mentioned above, using a non-network, TRICARE-authorized provider results in both a higher deductible and out-of-pocket costs. In overseas locations, TOP Select is available to eligible ADFMs not enrolled in TOP Prime and to retirees and their family members. Where the TRICARE network has not been established in an overseas location, TRICARE Select beneficiaries who receive medically necessary covered services from a non-network, TRICARE-authorized provider will be subject to cost-sharing amounts applicable to out-of-network care.

Take command of your health by making informed decisions about your TRICARE benefit. Learn more about your TRICARE options.

Air Force Medicine

Engage

Facebook Twitter
In a deployed setting, mental health providers assist commanders with maintaining their Airmen’s overall health in… https://t.co/fkowyMEwlP
Only one week left to enroll in the 2019 TRICARE and Federal Benefits Open Seasons - don't delay! For more informat… https://t.co/4MwUSbAOpL
Winners from the #TrustedCare "How Do You C.A.R.E.?" contest were recognized by Lt. Gen. Dorothy Hogg, Maj. Gen. (D… https://t.co/FeDfOom0Qu
77 years later, Pearl Harbor endures as a symbol of American resilience and resolve. Today we remember our brave se… https://t.co/Lach1Btol8
Lt. Gen. Hogg addressed AFMS leaders at #SLW18. "Now is time to shape the future of AFMS. Be disruptive innovators… https://t.co/mtYGTim0bO
6th MDG Airmen & Coast Guard members participate in a joint service Tactical Combat Casualty Care course at MacDill… https://t.co/2bU0vRubJB
#TBT: A U.S. Army flight nurse checks on a combat litter patient as he is loaded aboard a Douglas C-47 Skytrain at… https://t.co/xikEkX5bGI
RT @TRICARE: DYK? The TRICARE Open Season ends Dec. 10, 2018. Learn more about the next TRICARE webinar on Enrollment Options After TRICARE…
RT @USAFRecruiting: Air Force #Career: Prosthodontist. These specialists’ expertise in oral prostheses corrects dental appearance and makes…
Being safe is one of the easiest things you can accomplish every day and has direct impact on your health. Here are… https://t.co/0G8JnOnbKj
Our culture of #TrustedCare depends on continuous innovation. "Our hope is that local leaders will leverage our Tru… https://t.co/KhhMQr41vR
We make a difference. We are warriors. We are disruptive innovators. We are Airmen from the 17 enlisted medical car… https://t.co/8Gjy20uPQw
Medical material Airmen are working together with the 1st Special Operations Logistics Readiness Squadron to help r… https://t.co/JGu1vcCC6I
U.S. Air National Guard A1C Cheryl Graham, a health services technician with the 118th Medical Group, was a high pe… https://t.co/0Vn7xPkch3
RT @DHADirector: As the @DOD_DHA continues to integrate hospitals and the services, it's important to keep everyone informed on what's to c…
RT @DoDHealth: Had a great opportunity to speak with @USAFhealth leaders today. I look forward to our continued partnership to achieve a mo…
To ensure an effective relationships between military working dogs & their handlers, the 380th MDG, 380th Security… https://t.co/nmNRfg3C9X
The 2018 AFMS Senior Leadership Workshop kicked off this morning with welcome remarks by Lt Gen. Dorothy Hogg and C… https://t.co/YGbo4427iA
Eccrine Systems is conducting research under an Air Force Small Business Innovation Research and Small Business Tec… https://t.co/bE6Tpz0BYo
Check out the highlights of what happened around the AFMS in November 2018! https://t.co/e8jkhac14K