TRICARE East Humana Military: Guide & 2026 Rates | TRICARE.com

## Quick answer Humana Military is the managed care contractor for the **TRICARE East Region**, serving approximately 6 million beneficiaries across 30 states. They manage the provider networks, handle claims processing, and coordinate referrals for plans like TRICARE Prime and Select in the eastern half of the United States.

*Note: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense or TRICARE.mil.*

In detail

Effective January 1, 2025, the TRICARE program transitioned to the "T-5" contract. While the West region changed contractors, **Humana Military** retained the contract for the East region.

### East Region Coverage Area The East region spans from Maine to Florida and as far west as Texas and Oklahoma. It includes the following states: Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa (Rock Island area), Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (eastern half), Vermont, Virginia, West Virginia, and Wisconsin.

### Humana Military Responsibilities As the East region contractor, Humana Military is responsible for: * **Provider Network Management:** Recruiting and maintaining the "Network" of civilian doctors and hospitals. * **Claims Processing:** Paying your medical bills when you see a civilian provider. * **Referrals and Authorizations:** Reviewing requests from your PCM for specialty care. * **Enrollment:** Managing your enrollment in Prime or Select via the Humana Military portal. * **Customer Service:** Providing call centers for beneficiary support and grievance resolution.

### 2026 TRICARE East Costs (Group A) Costs vary based on your plan and when you (or your sponsor) joined the military. Below are select 2026 rates for **Group A** (Initial enlistment/commission before Jan 1, 2018):

| Service Type | TRICARE Prime (Network) | TRICARE Select (Network) | | :--- | :--- | :--- | | **Annual Enrollment Fee** | $391.92 (Individual) / $783.84 (Family) | $0 (Active Duty) / $188.88 (Retiree Individual) | | **PCP Office Visit** | $0 for Active Duty Family Members | $38 (Retirees) | | **Specialist Visit** | $0 for Active Duty Family Members | $51 (Retirees) | | **Urgent Care** | $0 | $38 (Retirees) | | **Catastrophic Cap** | $1,000 (ADFM) / $4,300 (Retirees) | $1,000 (ADFM) / $4,300 (Retirees) |

*Note: Active Duty Service Members (ADSMs) always have $0 out-of-pocket costs.*

## Who this applies to * **Active Duty Families:** If you live in the East region, Humana Military manages your access to civilian specialists and urgent care. * **Retirees and their Families:** Those under age 65 living in the East region must pay their annual enrollment fees directly to Humana Military. * **TRICARE Reserve Select (TRS) / Retired Reserve (TRRR) Members:** Members in the East region who purchase these premium-based plans. * **TRICARE Young Adult (TYA) Members:** Young adults residing in the East region.

Common scenarios

**1. A Retiree in Florida (Group A)** Jim is a retired Navy commander living in Orlando. He is enrolled in TRICARE Select. When he visits a network specialist in 2026, he pays a **$51 copay**. Humana Military processes the remainder of the bill and pays the doctor directly using the negotiated network rate.

**2. An Active Duty Spouse in Virginia** Sarah is married to an Army Sergeant at Fort Belvoir. She is enrolled in TRICARE Prime. Her PCM (at the military clinic) refers her to a civilian cardiologist in Alexandria. Sarah must wait for **Humana Military** to issue an authorization letter before her appointment to ensure the visit is covered at $0 out-of-pocket.

**3. Moving from California to North Carolina** The Miller family moves from San Diego (West Region) to Camp Lejeune (East Region). Because they moved into a new region, they must transition from TriWest Healthcare Alliance to **Humana Military**. They must update their address in DEERS and then contact Humana Military to transfer their Prime enrollment.

## Related terms * **T-5 Contract:** The fifth generation of TRICARE contracts, which began on January 1, 2025. * **PCM (Primary Care Manager):** Your main doctor who coordinates your care; in Prime, Humana Military ensures this doctor is in-network. * **DEERS:** The Defense Enrollment Eligibility Reporting System; Humana Military pulls your eligibility data from here. * **EOB (Explanation of Benefits):** The document Humana Military sends you after a claim is processed, showing what they paid and what you owe. * **Network Provider:** A doctor or facility that has a contract with Humana Military to provide care at discounted rates.

## Sources * **TRICARE East Region - Humana Military:** https://www.humanamilitary.com/ * **TRICARE.mil - East Region:** https://www.tricare.mil/East * **Defense Health Agency (DHA) - T5 Contract Awards:** https://health.mil/About-MHS/OASDHA/Defense-Health-Agency/Operations/Business-Operations/TC3/T5-Contract-Transition