Tricare

What Tricare does

TRICARE is the U.S. Department of Defense healthcare program administered by the Defense Health Agency (DHA) that provides comprehensive medical, dental, pharmacy, and mental health coverage to military beneficiaries worldwide. The program serves approximately 9.6 million active duty service members, National Guard and Reserve members, retirees, family members, survivors, and certain former spouses, integrating care delivered at DoD-operated military hospitals and clinics with a contracted civilian provider network across domestic regions (East via Humana Military, West via TriWest) and overseas areas (International SOS), with supplemental administration by WPS Government Services (TRICARE For Life), Express Scripts (pharmacy), and United Concordia (dental).

TRICARE's product portfolio is structured around two main plan families: managed care-style plans (TRICARE Prime, Prime Remote, Prime Overseas, Prime Remote Overseas, plus TRICARE For Life as Medicare wraparound) and self-managed preferred provider plans (TRICARE Select, Select Overseas), with premium-based options for non-active-duty populations (Reserve Select, Retired Reserve, Young Adult). Special programs include the Autism Care Demonstration, Extended Care Health Option, Continued Health Care Benefit Program, and Transitional Assistance Management Program. The underlying technology stack comprises the MHS GENESIS electronic health record patient portal, milConnect for eligibility verification, and regional contractor systems for claims and authorization management, with growing virtual health/telehealth delivery across regions.

The program is funded through congressional appropriations rather than commercial revenue, with beneficiary cost-sharing structured by plan type and sponsor Group (A: initial enlistment before January 1, 2018; B: after). Active duty service members receive care at no out-of-pocket cost; other beneficiaries pay regulated enrollment fees (e.g., $381.96-$462.96 annually for retiree Prime, depending on Group), monthly premiums for premium-based plans, and cost-shares for covered services. Distribution is non-commercial: TRICARE does not market to acquire customers, and beneficiaries are enrolled by eligibility status registered in DEERS rather than by purchasing a product.

Name

Tricare

Legal name

TRICARE (a registered trademark of the Department of Defense, Defense Health Agency)

Website

https://tricare.mil

Company type

Private

Founded year

1993

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

TRICARE is the U.S. Department of Defense healthcare program administered by the Defense Health Agency, providing comprehensive medical, dental, and pharmacy coverage to 9.6 million+ active duty service members, retirees, National Guard/Reserve members, and their families worldwide through military hospitals and contracted civilian networks.

Ownership category

akta.pro rank

Product category

Military Health Insurance

NAICS

Health Care and Social Assistance (62), Services for the Elderly and Persons with Disabilities (624120)

SIC

Services-Health Services (8000), Services-Offices & Clinics Of Doctors Of Medicine (8011)

akta.pro primary industry

Benefits, Insurance & Entitlement Navigation (Medicare/Medicaid/VA/LTC) (HSABAIAG)

Keywords

• Military healthcare
• Government health benefits
• Health insurance plans
• Pharmacy benefits
• Managed care

Headquarters

HQ city

Falls Church

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Operations, Personnel, Infrastructure, Technology or R&D, Others

Pricing tiers

Distribution channels7 records

Marketing channels6 records

Core offering

TRICARE is the U.S. Department of Defense healthcare program that provides comprehensive medical, dental, and pharmacy coverage to military service members, retirees, and their eligible family members. Coverage is delivered through a combination of military treatment facilities and civilian provider networks, with regional administration handled by contracted managed-care support contractors. Multiple health plan options are offered to match beneficiary status and geographic location.

Product overview

TRICARE is a comprehensive military healthcare program that brings together the health care resources of the Military Health System—including military hospitals and clinics—with a network of civilian health care professionals, institutions, pharmacies, and suppliers. The program offers multiple health plan options organized into two main categories: TRICARE Prime-based managed care plans (including TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Select, and TRICARE For Life) that provide coordinated care through primary care managers, and premium-based plans (including TRICARE Reserve Select, TRICARE Retired Reserve, and TRICARE Young Adult) that offer more flexibility. Supplemental programs include the Autism Care Demonstration, Extended Care Health Option, and pharmacy benefits administered by Express Scripts. The portfolio also includes dental programs through United Concordia and virtual health/telehealth services through the MHS GENESIS Patient Portal.

Differentiator

Problem solved

Functional benefit

Brands

• TRICARE Prime: TRICARE Prime is a health maintenance organization (HMO)-style plan with lower out-of-pocket costs but requires enrollees to use military hospitals and clinics as primary care managers when available.
• TRICARE Select
• TRICARE For Life
• TRICARE Reserve Select
• TRICARE Retired Reserve
• TRICARE Young Adult
• TRICARE Pharmacy Program
• TRICARE Dental Program

Products and services

• TRICARE Prime
• TRICARE Select
• TRICARE For Life
• TRICARE Reserve Select
• TRICARE Retired Reserve
• TRICARE Young Adult
• TRICARE Dental Program
• TRICARE Pharmacy Program

Segments6 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

Eight partnerships are on record, tiered core.

• Humana MilitarycoreChannel Partner/ Reseller/ DistributorHumana Military serves as the TRICARE East Region contractor, responsible for managing civilian healthcare networks, processing claims, and providing customer service to TRICARE beneficiaries in the Eastern United States. Beneficiaries can access the secure Beneficiary Self-Service portal through Humana Military for authorization status and claims information.
• TriWest Healthcare AlliancecoreChannel Partner/ Reseller/ DistributorTriWest Healthcare Alliance serves as the TRICARE West Region contractor, managing civilian provider networks, authorizations, claims processing, and customer service for beneficiaries in the Western United States. Contact number is 888-TRIWEST (874-9378).
• International SOS Government Services, LLCcoreChannel Partner/ Reseller/ DistributorInternational SOS Government Services administers TRICARE Overseas coverage across three geographic areas: TRICARE Eurasia-Africa, TRICARE Latin America and Canada, and TRICARE Pacific. Provides country-specific toll-free numbers and manages the MyCare Overseas mobile app and web portal for beneficiaries overseas.
• WPS Government ServicescoreChannel Partner/ Reseller/ DistributorWPS Government Services administers TRICARE For Life coverage for beneficiaries in the U.S. and U.S. territories who are eligible for Medicare. Contact: 866-773-0404 (TDD: 866-773-0405).
• Express ScriptscoreChannel Partner/ Reseller/ DistributorExpress Scripts administers the TRICARE Pharmacy Program, providing prescription drug coverage through military pharmacies, home delivery, and a network of retail pharmacies. The TRICARE Formulary is managed through Express Scripts, and beneficiaries can access prescription management tools through Express Scripts accounts and mobile app.
• United ConcordiacoreChannel Partner/ Reseller/ DistributorUnited Concordia administers the Active Duty Dental Program (ADDP) and the TRICARE Dental Program (TDP). The ADDP covers civilian dental care for active duty service members, while the TDP is a voluntary dental insurance plan for family members of active duty service members and National Guard/Reserve members.
• BENEFEDScoreChannel Partner/ Reseller/ DistributorBENEFEDS is the benefits administrator for the Federal Employees Dental and Vision Insurance Program (FEDVIP), offering voluntary dental and vision insurance plans for retired service members, their families, Medal of Honor recipients, and certain survivors through the U.S. Office of Personnel Management.
• Defense Health Agency (DHA)coreOthersThe Defense Health Agency is the component of the Military Health System that administers TRICARE. DHA operates military hospitals and clinics, manages healthcare contracts, and oversees the integration of military and civilian healthcare resources for TRICARE beneficiaries.

Scale indicators1 record

Recent moves6 records

Expansion highlights5 records

Direct peers

• Humana: Humana Military is the TRICARE East Region contractor, making Humana a direct operating peer. Humana also runs large Medicare Advantage and TRICARE-aligned government programs, sharing beneficiary management expertise with TRICARE.
• Veterans Health Administration (VA): The VA operates the largest integrated healthcare system in the U.S., providing direct care to veterans — a beneficiary population analogous to TRICARE's military beneficiary base. Both are federal healthcare programs with statutory mandates, integrated direct + purchased care models, and pharmacy operations.
• CHAMPVA: CHAMPVA is the Civilian Health and Medical Program of the Department of Veterans Affairs, providing healthcare benefits to dependents of veterans — directly analogous to TRICARE's family-member coverage model with similar cost-share structure and contractor claims processing.
• Health Net Federal Services: Health Net Federal Services is a major TRICARE contractor historically serving the West Region and TRICARE Overseas, providing direct comparability as a managed-care support contractor with deep familiarity administering military healthcare benefits.
• Medicare (Centers for Medicare & Medicaid Services): Medicare is the federal health insurance program for Americans 65+, providing direct comparability to TRICARE For Life, which functions as a Medicare-wraparound. Both are federally administered, eligibility-based programs serving large senior populations.

Broad incumbents

• Kaiser Permanente: Kaiser Permanente operates an integrated care delivery and insurance model that combines provider networks with health plan coverage — comparable to TRICARE's hybrid direct-care + civilian-network model and its emphasis on coordinated, capitated care.
• CVS Health (Aetna): CVS Health, through Aetna and Caremark, operates a vertically integrated health plan + PBM + retail pharmacy model serving government programs including Medicare and Medicaid — a broader-market analog to TRICARE's integrated medical and pharmacy benefit delivery.
• UnitedHealth Group: UnitedHealth Group, through UnitedHealthcare and Optum, is the largest U.S. health insurer with significant government program exposure (Medicare Advantage, Medicaid) — providing a scaled benchmark for managing large, federally-aligned beneficiary populations similar to TRICARE.
• Medicaid (CMS): Medicaid is the federal-state health coverage program for low-income Americans, sharing with TRICARE the model of government-funded healthcare with eligibility-based enrollment, managed care delivery, and contractor administration.

Emerging players

• Cigna / Express Scripts: Express Scripts (owned by Cigna) administers the TRICARE Pharmacy Program, providing pharmacy benefit management at scale for TRICARE beneficiaries. The Cigna-Evernorth platform is a comparable integrated health services and PBM operator.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/TRICARE
• Xx.com/TRICARE
• LinkedInlinkedin.com/company/wrnmmcdha

Revenue estimate

Valuation estimate

Number of profiles

Subsidiaries6 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Tricare