2026 TRICARE Changes, Costs, and Contractors Guide | TRICARE.com

*TRICARE.com is an independent reference site and is not a government agency. For official policy and enrollment, visit TRICARE.mil.*

## Quick answer In 2026, the TRICARE program continues to operate under the T-5 regional contract structure, with TriWest Healthcare Alliance managing the West Region and Humana Military managing the East Region. Beneficiaries should focus on the 2026 Open Season (typically mid-November to mid-December) to make plan changes for the following year and stay alert to updated catastrophic caps and enrollment fees for Group A and Group B retirees.

## In detail The year 2026 represents the second full year of the "T-5" contract generation, which fundamentally changed how the West Region operates. Following the transition in early 2025, the network stabilization is a primary focus for the Defense Health Agency (DHA).

### Regional Contractors (2026) * **East Region:** Humana Military continues as the contractor, providing services to beneficiaries in the eastern United States. * **West Region:** TriWest Healthcare Alliance manages the western United States. If you are experiencing network provider issues, ensure your "referral on file" aligns with TriWest’s 2026 provider directory. * **Pharmacy:** Express Scripts remains the single contractor for the TRICARE Pharmacy Home Delivery and retail network.

### 2026 Enrollment and Costs TRICARE costs are split into two categories: **Group A** (Sponsor enlisted before Jan. 1, 2018) and **Group B** (Sponsor enlisted on or after Jan. 1, 2018).

| Cost Category | Plan Type | 2026 Estimated Status | | :--- | :--- | :--- | | **Enrollment Fees** | Prime (Retirees) | Varies by Group — check TRICARE.mil for 2026 specifics | | **Annual Deductible** | Select | Group A and B have different deductibles; check current rates | | **Catastrophic Cap** | All Plans | Caps protect you from excessive out-of-pocket costs | | **Pharmacy Copays**| Retail / Home Delivery | Rates adjusted periodically; check Express Scripts for 2026 pricing |

### Key Dates for 2026 * **January 1, 2026:** New coverage year begins; deductibles and catastrophic caps reset to $0. * **Mid-November to Mid-December 2026:** TRICARE Open Season. This is the only time (outside of a Qualifying Life Event) that you can switch between Prime and Select or enroll in a new plan. * **Federal Benefits Open Season:** Occurs simultaneously with TRICARE Open Season for those eligible for FEDVIP dental and vision plans.

## Who this applies to * **Active Duty Service Members:** Impacted by 2026 network changes in the West Region but continue to have $0 out-of-pocket costs for authorized care. * **Retirees and Families:** Affected by annual adjustments to enrollment fees and the 2026 catastrophic cap limits. * **TRICARE Reserve Select (TRS) Members:** Must monitor 2026 monthly premium increases, which are typically announced in the late summer of the previous year. * **Young Adults:** Those aging out of regular TRICARE (at age 21 or 23) in 2026 may need to transition to TRICARE Young Adult (TYA).

Common scenarios

**Scenario 1: The New Retiree in 2026** Major Miller retires in June 2026. Because retirement is a Qualifying Life Event (QLE), he has 90 days to transition from TRICARE Prime (Active Duty) to TRICARE Prime or Select for Retirees. He must pay his first quarterly allotment of enrollment fees immediately to avoid a gap in coverage.

**Scenario 2: The Pharmacy User** Sarah uses a high-cost maintenance medication. In 2026, she checks the TRICARE Formulary Search Tool and sees that her brand-name drug has a higher copay at retail pharmacies. She switches to Express Scripts Home Delivery to save money on a 90-day supply, utilizing the 2026 mail-order rates.

**Scenario 3: West Region Specialist Visit** A Navy family in San Diego requires a specialist in March 2026. Since TriWest Healthcare Alliance is the contractor, the family must ensure their primary care manager (PCM) submits the referral through the TriWest portal, not the old Health Net system used prior to 2025.

## Related terms * **T-5 Contract:** The fifth generation of TRICARE contracts that restructured the regions and contractors. * **Open Season:** The annual window to change enrollment for the upcoming year. * **Qualifying Life Event (QLE):** A certain change in your life, such as marriage or birth, that allows you to change TRICARE plans outside of Open Season. * **Catastrophic Cap:** The maximum amount you will pay out-of-pocket for covered TRICARE services each year. * **FEDVIP:** The Federal Employees Dental and Vision Insurance Program, available to many TRICARE beneficiaries for supplemental coverage.

## Sources * TRICARE Official Site: [https://www.tricare.mil](https://www.tricare.mil) * Humana Military (East): [https://www.humanamilitary.com](https://www.humanamilitary.com) * TriWest Healthcare Alliance (West): [https://www.triwest.com](https://www.triwest.com) * DHA Contract Awards: [https://health.mil](https://health.mil)