Do Active Duty Military Pay for Health Insurance?

Many wonder if active duty military personnel pay for health insurance, and the structure of military healthcare can sometimes be misunderstood. This article clarifies the financial aspects of health coverage for active duty service members and their families, providing insight into how their healthcare system operates.

Health Coverage for Service Members

Active duty service members generally do not incur out-of-pocket costs for their healthcare. This means they pay no premiums, deductibles, or co-pays for covered medical services. This comprehensive coverage is a direct benefit.

The primary healthcare option for active duty service members is TRICARE Prime. Under this plan, their medical care is predominantly delivered through military treatment facilities (MTFs), which include military hospitals and clinics. Service members are assigned a primary care manager (PCM) within an MTF or a TRICARE Prime civilian network provider if an MTF is not readily available.

Prescription medications filled at military pharmacies, through TRICARE Pharmacy Home Delivery, or at TRICARE retail network pharmacies also typically have no co-payments for active duty service members. This benefit allows them to maintain their health and readiness without concerns about medical expenses.

Health Coverage for Family Members

While active duty service members have no direct healthcare costs, their family members may have different financial arrangements. Active duty family members also generally pay no annual enrollment fees for TRICARE Prime or TRICARE Select. However, out-of-pocket expenses can arise depending on the chosen TRICARE plan and the type of care received.

For active duty families enrolled in TRICARE Prime, there are typically no co-payments for medical services unless they use the point-of-service option, which allows them to seek care outside their assigned network without a referral, incurring higher costs. TRICARE Select, an alternative option, offers more flexibility in choosing providers but involves potential deductibles and cost-shares. For example, active duty families in TRICARE Select may have an annual deductible before TRICARE begins to share costs.

Pharmacy co-pays for family members can also vary based on the type of medication and where it is filled. While military pharmacies offer prescriptions at no cost, retail network pharmacies and home delivery services may involve co-payments for generic, brand-name, and non-formulary drugs.

Dental and vision coverage are separate programs. The TRICARE Dental Program is a voluntary, premium-based plan for active duty family members that involves monthly premiums and cost-shares for certain services. Monthly premiums for dental coverage in 2025 range from approximately $8.65 for a single E-4 and below family member to $29.98 for a family in E-5 and above. Routine eye exams for active duty family members are covered annually under TRICARE, regardless of the plan, but comprehensive vision coverage beyond routine exams may be obtained through the Federal Employees Dental and Vision Insurance Program (FEDVIP).

How TRICARE Works

TRICARE functions as the comprehensive healthcare system for uniformed service members, retirees, and their families worldwide. It integrates two main components to deliver healthcare services: direct care and purchased care. Direct care refers to medical services provided at military hospitals and clinics, which are Department of Defense facilities.

Purchased care, on the other hand, involves healthcare services obtained through a network of civilian providers, hospitals, and pharmacies that contract with TRICARE. When seeking specialty care, TRICARE Prime enrollees typically require a referral from their primary care manager.

The PCM initiates the referral process, which is then reviewed by the regional contractor. This process directs patients to the most appropriate care setting, whether a military facility or a civilian specialist. TRICARE’s design also extends its reach globally, providing coverage for beneficiaries located overseas through the TRICARE Overseas Program.