5 Things to Consider When Choosing a TRICARE Health Plan > TRICARE Newsroom > TRICARE News

Are you enrolled in or eligible for a TRICARE Prime or TRICARE Select plan? During TRICARE’s open season, you may be eligible to change plans or enroll in a plan for 2024. It’s important to understand your plan options so you can choose the right coverage for your family. That’s because the open season may be your only chance to change your plan for next year unless you have a qualifying life event.

Here are some things to consider when researching your plan options. Before researching plans, you need to know which plans your family members are eligible for. Eligibility depends on your sponsor status, your relationship with your sponsor, your location, and several other factors.

The TRICARE Plan Finder makes it easy to learn what your plan options may be. First you will answer a few short questions about yourself or a family member. The tool will then show you a list of plans you may be eligible for.

Reminder: TRICARE Open Season does not apply to active duty members. Active duty service members must be enrolled in a TRICARE Prime plan. This does not include the US Family Health Plan (USFHP). TRICARE Prime and TRICARE Select plans have different rules about how you get care.

With TRICARE Prime plans:

  • You will choose or be assigned a Primary Care Manager (PCM) to manage your care. Your PCM may be at a military hospital or clinic, or it may be a civilian provider.
  • You will need to get referrals from your PCM for specialty care and any care that your PCM cannot provide. However, you can see a specialist without a referral under the service option. This will result in higher out-of-pocket costs.
  • Your provider will file claims for you in most cases.

In some locations, you may be able to enroll in USFHP. It is a TRICARE Prime option available through networks of not-for-profit health systems in six areas of the United States. USFHP has slightly different rules for receiving care:

  • You will select a primary care provider from the network of physicians affiliated with the not-for-profit health systems in your designated USFHP area. This provider will coordinate your care and help you schedule appointments with specialists.
  • You cannot get care at military hospitals and clinics or from providers in the TRICARE network. You also cannot use express scripts. Instead, you will have a different network of pharmacies.

TRICARE Select is a self-managed care option that can give you more flexibility in choosing which providers to see. With TRICARE Select plans: Your health needs play a role in how you get care and what your costs will be. Think about the types of care you and your family may need in the coming year and how often you may need to receive care. Would you prefer to receive care outside of a military hospital or clinic? Depending on your health plan and the type of care you need, you may have the option of visiting any TRICARE-authorized provider. This can be a network or non-network provider. But choosing a network provider can minimize your out-of-pocket costs as outlined in TRICARE Choices in the United States handbook. Use the Find a Doctor tool to find TRICARE-authorized providers near you. When you follow your plan’s rules, TRICARE Prime usually has lower out-of-pocket costs than TRICARE Select. But keep in mind that TRICARE Select can offer you more flexibility in how you get care.

See TRICARE health plan costs for 2024 to compare plan costs and estimate your health care costs for next year. You may also want to review your pharmacy expenses for 2024.

Remember that TRICARE Open Season ends on Tuesday, December 12th. Go to TRICARE Open Season to learn more about your eligibility to participate in the open season, your plan options, and how to enroll in a plan.

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