TRICARE West Region Guide: Rates, States, and Plans (2026)

The **TRICARE West Region** is one of two primary management jurisdictions for military healthcare in the United States, covering 26 states. As of 2025, it is managed by **TriWest Healthcare Alliance** under the T-5 contract. If you live in the West Region, TriWest handles your provider network, referrals, authorizations, and claims processing.

*Note: TRICARE.com is an independent reference site and is not affiliated with the official TRICARE program. For official policies, visit TRICARE.mil.*

In detail

The TRICARE West Region underwent a significant transition on January 1, 2025, when TriWest Healthcare Alliance took over management from Health Net Federal Services (HNFS). This region covers roughly half the United States, stretching from the Mississippi River to the West Coast, plus Alaska and Hawaii.

### West Region Coverage Area The 26 states included in the West Region are: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas (excluding the El Paso area, which is East), Utah, Washington, Wisconsin, and Wyoming.

### Key Management Roles * **Regional Contractor:** TriWest Healthcare Alliance. They manage the provider network, process your medical claims, and oversee the customer service call centers. * **Pharmacy:** Express Scripts (consistent across all regions). * **Dental:** United Concordia or the TRICARE Dental Program (TDP).

### Health Plan Options in the West Residents in the West Region typically choose between: * **TRICARE Prime:** A managed care option similar to an HMO. Patients follow a Primary Care Manager (PCM) and require referrals for specialty care. * **TRICARE Select:** A self-managed PPO-style plan. Participants can see any TRICARE-authorized provider without a referral, though out-of-pocket costs are higher.

### Enrollment Fees and Costs (2026 Rates) Costs depend on your "Group" (determined by when you or your sponsor joined the military) and your plan type. * **Group A (Joined before 2018):** TRICARE Select annual enrollment fees for retirees are approximately $191.10 per individual or $382.20 per family (2026 rates). * **Group B (Joined 2018 or later):** Higher enrollment fees and different deductible structures apply. * **Active Duty:** Active duty service members (ADSMs) and their families pay $0 for TRICARE Prime enrollment.

### Transition to T-5 Contract The "T-5" contract, which began full operations in 2025, shifted six states from the East Region to the West Region to better balance beneficiary populations. These states include **Arkansas, Illinois, Louisiana, Oklahoma, Texas (excluding El Paso), and Wisconsin.** (Note: Illinois was later adjusted in final planning; always verify your specific zip code via the TRICARE website).

## Who this applies to * **Active Duty Service Members (ADSMs):** Must enroll in Prime and are typically assigned to a Military Treatment Facility (MTF) if living in a Prime Service Area. * **Active Duty Family Members (ADFMs):** Can choose between Prime (lower cost, less flexibility) or Select (no referrals needed, higher out-of-pocket). * **Retirees and Families:** Must pay annual enrollment fees to maintain coverage in either Prime or Select. * **National Guard and Reserve:** Those on active-duty orders for more than 30 days or those enrolled in TRICARE Reserve Select (TRS).

Common scenarios

**1. A Retiree in Arizona (Group A)** Jim is a retired veteran living in Phoenix. He is enrolled in **TRICARE Select**. For a 2026 specialist visit with an in-network provider, Jim pays a fixed copay (estimated at $37-$40 for 2026) without needing a referral from a primary doctor, provided he has met his annual deductible.

**2. Active Duty Spouse in California** Sarah’s husband is stationed at Camp Pendleton. She is enrolled in **TRICARE Prime**. Her PCM is at the base clinic. When she needs to see a dermatologist, her PCM submits a referral to **TriWest**. TriWest approves the request, and Sarah pays $0 for the visit because she is an active duty family member on Prime.

**3. Reserve Member in Washington State** Mark is a National Guard member using **TRICARE Reserve Select (TRS)**. He lives in Seattle. He pays a monthly premium (varies by year — check TRICARE.mil for 2026 rates) directly to TriWest and can see any authorized provider in the West Region network.

## Related terms * **TriWest Healthcare Alliance:** The private contractor responsible for administering TRICARE benefits in the West Region. * **T-5 Contract:** The fifth generation of TRICARE contracts which reorganized regional boundaries and contractors. * **Prime Service Area (PSA):** Geographic areas near military hospitals or clinics where TRICARE Prime is most available. * **Referral:** An order from your PCM to see a specialist, required for Prime members to avoid "Point of Service" charges. * **Network Provider:** A doctor or hospital that has a contract with TriWest to provide care at negotiated rates.

## Sources * **TRICARE West Region Official Site (TriWest):** https://www.triwest.com/ * **TRICARE.mil Regions Page:** https://www.tricare.mil/About/Regions * **Defense Health Agency (DHA):** https://health.mil/ * **TRICARE Cost Factors:** https://www.tricare.mil/costs