TriWest TRICARE West Region Guide (2026) | TRICARE.com

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## Quick answer TriWest Healthcare Alliance is the official TRICARE regional contractor for the **West Region**. As of January 1, 2025, TriWest manages the provider network, claims processing, and customer service for 26 states under the T-5 contract. If you live in the Western United States and use TRICARE Prime or Select, TriWest is the company responsible for your referrals and medical billing.

## In detail In early 2025, the Defense Health Agency (DHA) transitioned the West Region contract from Health Net Federal Services (HNFS) to **TriWest Healthcare Alliance**. This shift was part of the "T-5" contract generation, aimed at improving network access and electronic health record integration.

### Geography and Coverage The West Region managed by TriWest covers 26 states: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas (excluding the Areas of El Paso), Utah, Washington, and Wyoming.

### TriWest’s Primary Responsibilities 1. **Network Management:** Curating a list of authorized civilian doctors, specialists, and hospitals. 2. **Referrals and Authorizations:** Processing requests from your Primary Care Manager (PCM) when you need specialty care. 3. **Customer Service:** Operating call centers to assist with enrollment, eligibility questions, and finding providers. 4. **Claims Processing:** Paying doctors for services rendered to TRICARE beneficiaries. 5. **Enrollment:** Managing the annual Open Season enrollment changes for the West Region.

### 2026 Plan Administration TriWest administers several TRICARE plans in the West. While the *types* of plans are standard, the *network* of doctors is specific to TriWest:

| Plan Name | How TriWest Manages It | 2026 Enrollment Costs | | :--- | :--- | :--- | | **TRICARE Prime** | TriWest manages referrals to civilian specialists if military hospitals are full. | $391.56/yr (Individual, Group A Retirees) | | **TRICARE Select** | TriWest maintains a "preferred" network to keep out-of-pocket costs lower. | $189.96/yr (Individual, Group A Retirees) | | **TRICARE For Life** | TriWest acts as a secondary payer to Medicare for certain services in the West. | No enrollment fee |

*Note: 2026 rates for Group B/active duty vary — check TRICARE.mil for specific tier-based figures.*

## Who this applies to * **Active Duty Service Members (ADSMs):** Located in the West Region; they must coordinate all civilian care through TriWest. * **Active Duty Family Members (ADFMs):** Using Prime or Select in Western states. * **Retirees and Families:** Under age 65 living in the West who are not yet eligible for Medicare. * **National Guard and Reserve:** Members using TRICARE Reserve Select (TRS) within the 26-state TriWest territory.

Common scenarios

### 1. Seeking Specialty Care in Seattle John is a TRICARE Prime beneficiary in Washington. His military PCM determines he needs a cardiologist. Because the local Military Treatment Facility (MTF) is at capacity, the PCM sends a request to **TriWest**. John receives an authorization letter from TriWest within 3–5 business days directing him to a specific civilian cardiologist in the TriWest network. For 2026, John’s copay for this specialty visit is $0 as an active duty family member.

### 2. Using TRICARE Select in Phoenix Sarah is a retired Navy commander living in Arizona using TRICARE Select. She does not need a referral. She uses the **TriWest Provider Directory** to find a "Network" orthopedist. Because she chose a TriWest network provider, her 2026 copay is approximately $35–$50 (varies by retiree group), whereas going to an "Out-of-Network" provider would result in a 25% cost-share.

### 3. Moving from East to West The Miller family moves from Georgia (East Region/Humana) to Colorado (West Region/TriWest). They must contact TriWest to update their enrollment. Their benefits stay the same, but their "back-office" manager and the pool of available doctors switch from Humana Military to TriWest Healthcare Alliance.

## Related terms * **T-5 Contract:** The fifth generation of TRICARE contracts that began full implementation in 2025. * **Defense Health Agency (DHA):** The government body that oversees TRICARE and manages the contractors. * **East Region:** The other half of the US TRICARE map, currently managed by Humana Military. * **PCM (Primary Care Manager):** The doctor who coordinates your care; if you are in the West, your PCM works with TriWest for authorizations. * **Network Provider:** A doctor who has a contract with TriWest to provide care at discounted, pre-negotiated rates.

## Sources * **TriWest Healthcare Alliance:** https://www.triwest.com/ * **TRICARE West Region Official Page:** https://www.tricare.mil/West * **Defense Health Agency T-5 Information:** https://health.mil/Military-Health-Topics/Business-Support/Partnering-with-the-DHA/TRICARE-Health-Plan-Contracts