Welcome to TRICARE.com: Your Independent Health Guide | TRICARE.com

## Quick answer TRICARE.com is an independent, non-government reference resource designed to help military members and their families navigate the complexities of their health benefits. While the official government portal is TRICARE.mil, this site provides simplified guides, updated 2026 rates, and clear explanations of how to maximize your coverage under contractors like Humana Military and TriWest.

## In detail Navigating military healthcare can be overwhelming due to shifting contracts, regional splits, and annual cost updates. As of April 2026, the TRICARE system operates under the T-5 contract, which brought significant changes to how care is managed in the United States.

### The Two Regions (T-5 Contract) The United States is divided into two geographic regions. Your primary point of contact for authorizations and provider networks depends on where you live:

* **TRICARE East Region:** Managed by **Humana Military**. This covers the eastern half of the U.S. from Maine to Florida and west to Texas. * **TRICARE West Region:** Managed by **TriWest Healthcare Alliance**. TriWest took over the West Region contract effective January 1, 2025. If you are in the West, you no longer use Health Net Federal Services (HNFS).

### Primary Plan Options in 2026 Most beneficiaries fall into one of three main categories:

1. **TRICARE Prime:** A managed care option similar to an HMO. Active Duty Service Members (ADSMs) must use Prime. It typically has the lowest out-of-pocket costs but requires referrals for specialty care. 2. **TRICARE Select:** A self-managed, preferred provider organization (PPO) model. It offers the most flexibility to see providers without a referral but involves annual deductibles and cost-shares. 3. **TRICARE For Life (TFL):** Medicare-wraparound coverage for military retirees and their spouses who are age 65 or older and have Medicare Part A and B.

### 2026 Cost Structure (Groups A & B) Costs are determined by when the sponsor joined the military: * **Group A:** Sponsor enlisted or was appointed before Jan. 1, 2018. * **Group B:** Sponsor enlisted or was appointed on or after Jan. 1, 2018.

| Category | TRICARE Prime (Retirees) | TRICARE Select (Retirees) | | :--- | :--- | :--- | | **Annual Enrollment Fee** | Varies by year ($380+ for individuals) | Varies by year ($180+ for individuals) | | **Primary Care Copay** | ~$25 - $30 (2026 rates) | ~$35 - $40 (2026 rates) | | **Specialty Care Copay** | ~$40 - $50 (2026 rates) | ~$55 - $70 (2026 rates) | | **Pharmacy (30-day Retail)** | $16 (Generic) / $43 (Brand) | $16 (Generic) / $43 (Brand) |

### Pharmacy and Overseas Coverage Regardless of your U.S. region, pharmacy benefits are managed globally by **Express Scripts**. If you are stationed or living overseas, your care is coordinated by **International SOS** through the TRICARE Overseas Program (TOP).

*Note: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense. For official policy and enrollment, visit TRICARE.mil.*

## Who this applies to * **Active Duty Service Members:** Mandatory enrollment in Prime; $0 out-of-pocket for all authorized care. * **Active Duty Families:** Can choose Prime ($0 premiums) or Select (no referrals, but has deductibles). * **National Guard & Reserve:** Eligible for TRICARE Reserve Select (TRS) while in a non-activated status, requiring monthly premiums. * **Retirees and Families:** Must pay annual enrollment fees for Prime or Select and are subject to cost-shares. * **Medicare-Eligible Retirees:** Automatically transition to TRICARE For Life if they maintain Medicare Part B.

Common scenarios

**1. The "Select" Choice in the West** An Army retiree living in Arizona (West Region - TriWest) uses TRICARE Select. In 2026, they see a civilian dermatologist without a referral. They pay their annual deductible (approx. $150–$300) and then a 25% cost-share for the visit, enjoying the freedom to choose their specialist.

**2. The Prime Family in the East** A Navy family stationed in Virginia (East Region - Humana Military) is enrolled in TRICARE Prime. The spouse needs physical therapy. They visit their Primary Care Manager (PCM), get a referral, and pay $0 for the therapy sessions as long as they stay within the network.

**3. Pharmacy Mail Order** A retiree taking maintenance blood pressure medication uses Express Scripts Home Delivery. For a 90-day supply of a generic drug in 2026, they pay $13, saving significantly compared to three separate $16 copays at a retail pharmacy.

## Related terms * **DEERS:** The Defense Enrollment Eligibility Reporting System; the database that confirms you are eligible for TRICARE. * **Catastrophic Cap:** The maximum amount you will pay out-of-pocket for covered services each calendar year. * **PCM:** Primary Care Manager; the provider (military or civilian) who coordinates your care in a Prime plan. * **MTF:** Military Treatment Facility; a hospital or clinic located on a military base. * **T-5 Contract:** The fifth generation of TRICARE managed care contracts, which transitioned the West region to TriWest in 2025.

## Sources * **TRICARE Official Website:** [https://www.tricare.mil](https://www.tricare.mil) * **Humana Military (East Contractor):** [https://www.humanamilitary.com](https://www.humanamilitary.com) * **TriWest Healthcare Alliance (West Contractor):** [https://www.triwest.com](https://www.triwest.com) * **Express Scripts TRICARE Pharmacy:** [https://militaryrx.express-scripts.com](https://militaryrx.express-scripts.com)