TRICARE West & TriWest Healthcare Alliance Guide

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

## Quick answer In the context of TRICARE, "Alliance" most commonly refers to the **TriWest Healthcare Alliance**, the regional contractor responsible for managing the TRICARE West Region. As of January 1, 2025, TriWest took over West Region operations under the T-5 contract, serving millions of service members, retirees, and their families across 26 states.

## In detail While "Alliance" sounds like a specific medical plan, it is actually the name of the organization (TriWest Healthcare Alliance) that administers TRICARE benefits. If you live in the West Region, TriWest is your primary point of contact for authorizations, referrals, and provider networks.

### The West Region Transition (T-5 Contract) Effective January 1, 2025, the Department of Defense shifted West Region management from Health Net Federal Services (HNFS) to TriWest Healthcare Alliance. This "alliance" of healthcare systems and providers manages the delivery of care for beneficiaries in states ranging from Alaska to Texas.

### Key Responsibilities of TriWest Healthcare Alliance * **Network Management:** Maintaining the list of "In-Network" providers for TRICARE Prime and Select. * **Referrals and Authorizations:** Processing requests from Primary Care Managers (PCMs) to see specialists. * **Customer Service:** Operating call centers for claims and enrollment issues in the West Region. * **Claims Processing:** Paying doctors and hospitals for covered services rendered to beneficiaries.

### TRICARE West States (2026) TriWest manages care in: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Illinois (certain areas), Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wisconsin, and Wyoming.

### 2026 Cost Shares in the West Region Costs are determined by your plan and sponsor status, not by the contractor. For 2026, typical costs for Group A (Initial enlistment before 2018) include:

*Note: Active Duty Service Members and their families typically have $0 out-of-pocket costs on Prime.*

## Who this applies to * **Active Duty Service Members (ADSMs):** Stationed in the West Region who require specialty care referrals through TriWest. * **Active Duty Family Members (ADFMs):** Living in the West Region using Prime or Select. * **Retirees and Families:** Those living in the 26 West Region states who must pay enrollment fees and co-pays to TriWest. * **Providers:** Doctors in the Western US who must contract with TriWest Healthcare Alliance to be considered "In-Network."

Common scenarios

**1. Moving from East to West** Major Miller moves from Fort Liberty, NC (East Region/Humana) to Fort Carson, CO (West Region/TriWest) in March 2026. He must transfer his enrollment to the West Region. His healthcare is now managed by the TriWest Healthcare Alliance, and his new PCM will send all referral requests to TriWest instead of Humana.

**2. A Retiree Specialist Visit** Sarah, a retired Navy Commander in San Diego, uses TRICARE Select. In 2026, she visits an orthopedic specialist. Because she is in the West Region, the specialist files the claim with TriWest Healthcare Alliance. Sarah pays her $50 co-pay (2026 rate for Group A retirees) because she used a network provider managed by the Alliance.

**3. Seeking Urgent Care** An Army spouse in Seattle needs urgent care on a Saturday in 2026. Under TriWest (West Region) rules, Prime beneficiaries can typically use a network Urgent Care Center without a referral. They use the TriWest provider search tool to find an "Alliance" network facility to avoid point-of-service charges.

## Related terms * **T-5 Contract:** The fifth generation of TRICARE managed care contracts that began in 2025. * **Regional Contractor:** A private company (like TriWest or Humana) that manages TRICARE benefits for a specific geographic area. * **Network Provider:** A doctor or hospital that has a formal agreement with the regional contractor (TriWest) to provide care at negotiated rates. * **Humana Military:** The East Region contractor, the counterpart to TriWest Healthcare Alliance. * **Express Scripts:** The pharmacy benefit manager that handles prescriptions for both regions.

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