TRICARE Palliative Care: Coverage, Costs, and Rules (2026)

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

## Definition Palliative care is specialized medical care focused on providing relief from the symptoms and stress of a serious illness to improve quality of life for both the patient and the family.

## What it means in practice For TRICARE beneficiaries, palliative care is often confused with hospice, but there is a critical distinction: you can receive palliative care at any stage of a serious illness, even while you are still seeking curative treatment. TRICARE covers palliative care as part of a comprehensive treatment plan for life-threatening or chronic conditions, such as cancer, heart failure, or end-stage renal disease. The goal is to manage symptoms like pain, shortness of breath, fatigue, or nausea, while also providing emotional and spiritual support.

In practice, this care is usually delivered by a multidisciplinary team of doctors, nurses, and social workers. If you are enrolled in **TRICARE Prime**, you generally need a referral from your Primary Care Manager (PCM) to see a palliative care specialist. For **TRICARE Select** users, no referral is typically required, though you will save money by using a network provider. Under the current T-5 contract, these services are coordinated by **Humana Military** in the East Region and **TriWest Healthcare Alliance** in the West Region.

The cost of palliative care depends on your beneficiary status and the setting of the care. For 2026, active-duty service members (ADSMs) have $0 out-of-pocket costs. For Group A retirees on TRICARE Select, a specialty office visit may require a copayment (typically around $37–$50 per visit for 2026, though specific rates vary by exact plan and status). If the care is provided during an inpatient hospital stay, it is typically bundled into the hospital’s DRG (Diagnosis Related Group) payment rather than billed as a separate palliative line item.

One unique aspect of the TRICARE benefit is the **Childhood Cancer Care Pilot** and other specialty programs that prioritize "concurrent care." This means that for children, TRICARE specifically allows for palliative services to be delivered alongside life-prolonging treatments without the restrictive "six-month life expectancy" requirement found in the adult hospice benefit.

## Related terms * **Hospice Care:** End-of-life care for patients with a terminal prognosis of six months or less, where curative treatment has stopped. * **Case Management:** A service provided by regional contractors (Humana or TriWest) to help patients with complex needs coordinate multiple specialists. * **Curative Treatment:** Medical care intended to cure a patient's disease or condition rather than just managing symptoms. * **Advance Directive:** A legal document that specifies what actions should be taken for a patient's health if they are no longer able to make decisions for themselves. * **Cost-Share:** The percentage of the TRICARE-allowed amount you pay for services after you have met your annual deductible.

## Sources * TRICARE.mil: [Hospice and Palliative Care](https://www.tricare.mil/CoveredServices/IsItCovered/HospicePalliativeCare) * Defense Health Agency: [TRICARE Policy Manual - Palliative Care](https://manuals.health.mil/) * TriWest Healthcare Alliance: [West Region Provider Portal](https://www.triwest.com)