Editor’s Note: This article by MOAA staff is part of MOAA’s 2025-26 TRICARE Guide, brought to you by MOAA Insurance Plans, administered by Association Member Benefits Advisors (AMBA). A version of the guide appeared in the November 2025 issue of Military Officer magazine. 

Retiring from military service means your options for health care will change and might cost you more. An important step in planning ahead for retirement is to evaluate the health care options available to you and consider the costs.

TRICARE beneficiaries in the U.S. and its territories may choose between TRICARE Prime and TRICARE Select. Military retirees and their dependents living outside the U.S. can use TRICARE Select Overseas. Prime and Select provide identical treatment of covered medical services. The differences: Prime can cost less; Select provides greater flexibility in accessing care.

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Here’s how to prepare for the transition into retired status:

Steps to Take

• Starting months before retiring from the military, compare the available TRICARE plans to choose what’s best for you and your family.
  
  
• Spouses may sign up for a different plan than the military retiree and pay an individual rate for their plan versus the family rate.
  
  
• Check that your status is updated to “retired” on the Defense Enrollment Eligibility Reporting System (DEERS).
  
  
• When the DEERS status reflects “retired,” and within 90 days of your retirement date, enroll in your choice of TRICARE plan.
  
  
• Contact the specific regional contractor that manages the program in your area. Enrollment can be done online, by telephone, or through U.S. mail.
  
  

[COMPARE PLANS: TRICARE.mil]

Here are the programs to compare:

TRICARE Prime

Retiree beneficiaries pay enrollment fees and network copays. The enrollment fee for 2025, adjusted for COLA, is $372 for individuals and $744 for families. A primary care manager (PCM) provides most of your care in Prime service areas.

Consider these options for health care:

• Military treatment facility (MTF): Check with the contractor to see whether an MTF near you, within a 30-minute drive, accepts new retirees and families. Check on the status of your preferred MTF during the next open season or qualifying life event.
  
  
• Civilian care: In many metropolitan areas, TRICARE contracts with medical providers to offer this option. You will incur copays for civilian care.
  
  
• Specialty care: An option to cut costs is to look for a TRICARE provider for specialty care. With TRICARE Prime, you should get a referral for a specialist. A deductible and higher copays are charged for
  point-of-service care and do not count against your catastrophic cap.

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TRICARE Select

Select is the most flexible TRICARE program. It is a preferred provider organization (PPO) plan. You don’t need a PCM, and you can manage your own care. You will need to find medical care providers who accept TRICARE, which contracts with a network of doctors, hospitals, and other providers.

Retirees pay annual enrollment fees adjusted for COLA each calendar year. The 2025 fee is $181.92 for individuals and $364.92 for families. Copays are higher than those for Prime. Fees and deductibles for covered services count against the catastrophic cap, which is $4,261 for 2025.

TRICARE Select Overseas

Military retirees and their dependents living overseas can use TRICARE Select Overseas. (TRICARE Prime Overseas is only for active duty and their families.) The enrollment fee is the same as for TRICARE Select. For 2025, the fee is $181.92 for individuals and $364.92 for families.

Enrollment fees count against the $4,261 catastrophic cap.

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Your Catastrophic Cap

The catastrophic cap is the most you pay out of pocket for covered services in a calendar year before TRICARE picks up additional covered costs. Prime and Select enrollment fees count against the catastrophic cap. In your retirement year, the amount accrued while on active duty rolls into the retirement catastrophic cap.

The catastrophic cap for Prime goes up from $1,000 for active duty to $3,000 for retirees. The 2025 cap is $4,261. It is adjusted for COLA each year.

Pharmacy Benefit

Military retirees and dependents have a copay for prescriptions from commercial pharmacies or home delivery through Express Scripts.

Prescriptions remain free within the MTF system.

Group A/Group B Designations

Two categories determine the fee structure for enrollment, deductibles, copays, and catastrophic caps:

• Group A: All servicemembers and their families who entered service prior to Jan. 1, 2018.
• Group B: Those entering on or after Jan. 1, 2018.

Terminal Leave

A retiring servicemember stays enrolled in TRICARE Prime at their last duty station until the retirement date. Here’s where they can get care:

• Any military hospital or clinic. Pre-authorizations are required for nonurgent care.
• VA medical facilities with a referral/pre-authorization.

For routine medical care during terminal leave, or if you plan to leave the area of the last duty station at that time, consult with the TRICARE referral office at your MTF or the Defense Health Agency-Great Lakes at (888) 647-6676.

Military families are covered by their TRICARE plan until the date of retirement. Families enrolled in an MTF stay enrolled with their providers until the retirement date unless there is a reason to change, such as a PCS move. Families can switch plans or stay with the current plan and enroll with a TRICARE Prime PCM at the new location.