TRICARE West Guide: 2026 Costs, States & TriWest Info | TRICARE.com

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## Quick answer TRICARE West is the geographic region covering 26 western U.S. states managed by the regional contractor **TriWest Healthcare Alliance**. As of 2026, TriWest is responsible for building the provider network, processing claims, and managing authorizations for millions of service members and their families living in the western half of the country.

## In detail The TRICARE West region is currently operating under the "T5" contract, which began full implementation on January 1, 2025. This transition moved the regional management from Health Net Federal Services (HNFS) to TriWest Healthcare Alliance.

### Covered States The West Region includes Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (except the Rock Island Arsenal area), Kansas, Minnesota, Missouri (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas (western areas including El Paso), Utah, Washington, and Wyoming.

### Role of the Regional Contractor (TriWest) TriWest Healthcare Alliance performs the following functions for beneficiaries in the West: * **Provider Network:** Recruits and maintains the network of civilian doctors, specialists, and hospitals. * **Referrals/Authorizations:** Processes requests from Primary Care Managers (PCMs) for specialty care. * **Claims Processing:** Pays healthcare providers for covered services. * **Customer Service:** Operates call centers and online portals for enrollment and billing.

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

| Plan Name | Primary Feature | 2026 Cost Structure (Example) | | :--- | :--- | :--- | | **TRICARE Prime** | HMO-style; assigned a PCM at a Military Hospital or within TriWest network. | No enrollment fee for ADSMs/ADFMs. 2026 retiree fees vary by Group. | | **TRICARE Select** | PPO-style; use any TRICARE-authorized provider. | Annual deductible ($150–$300+) and cost-shares apply. | | **TRICARE For Life** | Medicare-wraparound for age 65+. | No enrollment fees; TriWest handles secondary claims. |

### 2026 Enrollment Costs (Group A Example) * **Active Duty Family Members:** $0 enrollment fee; $0 for covered services at MTFs or with referrals. * **Retirees (Group A):** For TRICARE Prime, the 2026 annual enrollment fee is approximately $391.92 for individuals and $783.84 for families (varies by plan year—check TRICARE.mil for specific updates). * **TRICARE Select Catastrophic Cap:** Prevents families from paying more than a set amount (e.g., $4,399 for retirees in 2026) in out-of-pocket costs per year.

## Who this applies to * **Active Duty Service Members (ADSMs):** Stationed at western bases (e.g., JBLM, Camp Pendleton, Fort Bliss). They must enroll in TRICARE Prime. * **Active Duty Family Members (ADFMs):** Living in the West region. They can choose between Prime (managed care) or Select (freedom of choice). * **Retirees and Families:** Those living in the 26 western states who are under age 65. * **National Guard/Reserve:** Members living in the West who are using TRICARE Reserve Select (TRS).

Common scenarios

### Scenario 1: Specialty Care Referral Sarah is an Active Duty spouse in San Diego (TRICARE West) assigned to a Navy PCM. She needs to see a dermatologist. Her PCM submits a referral to **TriWest**. Within 3–5 business days, Sarah logs into the TriWest portal to view her authorization letter, which directs her to a specific network specialist in San Diego. Her 2026 copay is $0 because she is an ADFM on Prime.

### Scenario 2: Retiree Using TRICARE Select John is a retired Army officer living in Montana. He uses TRICARE Select to see a local civilian doctor who is not at a military base. For a 2026 office visit, John pays a $30–$40 copay (after his deductible is met) because he is in "Group A." TriWest processes the claim and pays the remainder of the allowable charge directly to the doctor.

### Scenario 3: Moving from East to West Chief Petty Officer Miller moves from Norfolk, VA (East Region/Humana) to Bremerton, WA (West Region/TriWest). He must contact TriWest to "enroll" in the West region. His medical records stay in the DEERS system, but his primary care management shifts to the TriWest network.

## Related terms * **T5 Contract:** The fifth generation of TRICARE managed care contracts that began in 2025. * **TriWest Healthcare Alliance:** The private company contracted by the DoD to run the West region. * **Network Provider:** A doctor or hospital that has a contract with TriWest to provide care at discounted rates. * **DEERS:** The Defense Enrollment Eligibility Reporting System; the database that proves you are eligible for TRICARE. * **PCM:** Primary Care Manager; your main doctor who coordinates all care in the Prime plan.

## Sources * **TRICARE West Official Site:** [https://www.tricare-west.com](https://www.tricare-west.com) * **TRICARE.mil Regions Page:** [https://www.tricare.mil/About/Regions](https://www.tricare.mil/About/Regions) * **TriWest Healthcare Alliance:** [https://www.triwest.com](https://www.triwest.com) * **Defense Health Agency (DHA):** [https://health.mil](https://health.mil)