TRICARE East: Plans, Costs, and Humana Military Guide | TRICARE.com

TRICARE East is the geographic region covering the eastern United States, managed by Humana Military. Under this contract, beneficiaries access a network of civilian and military providers across 30 states from Maine to Texas.

*Note: TRICARE.com is an independent reference site and is not the official TRICARE program or affiliated with the Department of Defense. For official policy and enrollment, visit [TRICARE.mil](https://www.tricare.mil).*

## Quick answer TRICARE East is the healthcare management region covering the eastern half of the U.S., including Washington D.C. It is managed by **Humana Military**, which handles provider networks, claims processing, and customer service for millions of service members and their families. If you live in this region, your enrollment and authorizations are handled through the Humana Military portal.

In detail

The TRICARE East region is one of two primary regions in the United States (the other being the West region, managed by TriWest). Following the implementation of the T-5 contract, the administrative boundaries remained relatively stable, but the management focuses on a unified provider network to ensure "readiness" for the Department of Defense.

### Areas Covered TRICARE East includes the following 30 states: Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (excluding the El Paso area), Vermont, Virginia, West Virginia, and Wisconsin. It also includes the District of Columbia.

### Plan Options in the East Region Beneficiaries in the East region typically choose between these primary plans:

* **TRICARE Prime:** A managed-care option similar to an HMO. Most care is received at a Military Treatment Facility (MTF) or through a primary care manager (PCM) in the Humana Military network. * **TRICARE Select:** A self-managed, preferred provider organization (PPO) plan. You can see any TRICARE-authorized provider, but you pay lower out-of-pocket costs if you use a provider within the Humana Military network. * **TRICARE for Life:** For retirees with Medicare Parts A and B; Humana Military acts as the secondary payer for TRICARE-covered services.

### 2026 Costs and Fees Costs depend on the beneficiary’s "Group" status (Group A joined before Jan 1, 2018; Group B joined on or after that date). Below are representative 2026 rates for Active Duty Family Members (ADFMs) and Retirees:

| Fee Type | TRICARE Prime (Retirees) | TRICARE Select (Retirees - Group A) | | :--- | :--- | :--- | | **Annual Enrollment** | ~$390 (Individual) / ~$780 (Family) | ~$195 (Individual) / ~$390 (Family) | | **Annual Deductible** | $0 | $150 (Individual) / $300 (Family) | | **Primary Care Visit** | $25 copay (Network) | $32 copay (Network) | | **Specialty Visit** | $37 copay (Network) | $50 copay (Network) | | **ER Visit** | $75 copay | $145 copay |

*Note: Active Duty Service Members (ADSMs) have $0 out-of-pocket costs for all covered TRICARE Prime services.*

### Managing Your Care In the East Region, Humana Military is responsible for: * **Provider Directory:** Maintaining the list of network doctors and hospitals. * **Referrals/Authorizations:** Reviewing requests from PCMs for specialty care. * **Claims:** Processing payments to providers. * **Dispute Resolution:** Handling appeals for denied claims or authorizations.

## Who this applies to * **Active Duty Service Members (ADSMs):** Stationed at bases within the 30 eastern states; must enroll in TRICARE Prime. * **Active Duty Family Members (ADFMs):** Living in the East region; may choose Prime or Select. * **Retirees and their Families:** Living in the East region; must pay annual enrollment fees to maintain coverage. * **National Guard/Reserve:** Members living in the East region using TRICARE Reserve Select (TRS).

Common scenarios

**1. Moving from West to East** Staff Sergeant Jones moves from California (West Region) to Fort Liberty, North Carolina (East Region) in June 2026. He must contact Humana Military to transfer his enrollment. Because he is Active Duty, his TRICARE Prime coverage remains $0 out-of-pocket, but he will be assigned a new PCM at Womack Army Medical Center.

**2. A Retiree Using Select in Florida** A retired Navy Commander (Group A) living in Jacksonville uses TRICARE Select. In 2026, she sees a network specialist for a consultation. She pays her $150 annual deductible first, then a $50 copay for the visit. Humana Military processes the remainder of the bill directly with the doctor.

**3. Emergency Care While Traveling** An East region beneficiary is visiting family in Maine and goes to an Emergency Room. Because it is a "true emergency," the $75 copay (for Prime retirees) or $145 copay (for Select retirees) applies, and Humana Military handles the claim regardless of whether the hospital is "in-network," provided they are notified within 24–48 hours.

## Related terms * **Humana Military:** The private contractor that manages the TRICARE East region. * **Network Provider:** A doctor or facility that has a contract with Humana Military to provide care at negotiated rates. * **PCM (Primary Care Manager):** The doctor responsible for your basic care and for coordinating referrals to specialists (required for Prime). * **T-5 Contract:** The fifth generation of TRICARE contracts which began full implementation in 2025. * **Catastrophic Cap:** The maximum amount you will pay out-of-pocket for covered services each calendar year.

## Sources * **TRICARE.mil - East Region:** https://www.tricare.mil/About/Regions/East * **Humana Military (Official Site):** https://www.humanamilitary.com/ * **Defense Health Agency (DHA):** https://health.mil/Military-Health-Topics/Business-Support/TRICARE-Health-Plan