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TRICARE News Updates: 2026 Guide to Changes

Stay current with 2026 TRICARE news, including T-5 contract updates for the West Region, new pharmacy copay rates, and Open Season dates.

TRICARE News Updates: 2026 Guide to Changes

*Disclaimer: TRICARE.com is an independent reference site and is not affiliated with the official TRICARE program or the Department of Defense. For official policy and the most current data, visit TRICARE.mil.*

## Quick answer As of May 2026, the TRICARE landscape is defined by the full implementation of the T-5 regional contracts and evolving pharmacy benefits. Key updates include TriWest Healthcare Alliance’s management of the West Region, Humana Military’s continued oversight of the East Region, and shifts in copayments for mail-order prescriptions. Staying updated ensures you avoid out-of-network penalties and maximize your 2026 benefits.

In detail

### 1. Regional Contract Stabilization (T-5) The transition to the "T-5" contract, which began in early 2025, has now reached a stabilized state. The most significant shift remains the West Region's move to **TriWest Healthcare Alliance**.

* **East Region:** Remains under Humana Military. * **West Region:** Managed by TriWest Healthcare Alliance (replacing the former contractor, Health Net Federal Services). * **The "Frontier" Effect:** In 2026, both contractors have expanded their "provider steering" tools, which help beneficiaries find high-value providers with lower out-of-pocket costs.

### 2. 2026 Pharmacy Benefit Changes Express Scripts continues as the Pharmacy Benefit Manager. For 2026, the "Home Delivery" (mail order) remains the most cost-effective option for maintenance medications.

| Fulfillment Method | Generic (2026) | Brand (2026) | Non-Network (2026) | | :--- | :--- | :--- | :--- | | **Military Pharmacy** | $0 | $0 | N/A | | **TRICARE Pharmacy Home Delivery** | $15–$17* | $34–$38* | Not applicable | | **Retail Network Pharmacy** | $18–$20* | $48–$52* | Higher costs apply |

*\*Note: Exact 2026 rates may vary by specific tier—check TRICARE.mil or Express Scripts for the finalized seasonal schedule.*

### 3. Open Season 2026 The annual TRICARE Open Season typically runs from mid-November to mid-December. This is the only time (outside of a Qualifying Life Event) that beneficiaries can switch between TRICARE Prime and TRICARE Select. Changes made during the late 2025 Open Season are currently in effect for the 2026 calendar year.

### 4. Expansion of Telehealth Options Following the permanent adoption of many COVID-era flexibilities, 2026 news focuses on the integration of "Telemental Health." TRICARE has expanded the number of authorized providers who can offer behavioral health services via secure video, reducing wait times for specialty care in rural areas.

## Who this applies to * **Active Duty Service Members (ADSMs):** Must remain in TRICARE Prime; updates primarily affect their referral processes under the new West Region contractor (TriWest). * **Active Duty Family Members (ADFMs):** Impacted by annual changes in enrollment fees (for Select) and pharmacy copay increases. * **Retirees and their Families:** Most affected by the 2026 "Group A" vs. "Group B" cost-sharing structures and pharmacy rate hikes. * **TRICARE For Life (TFL) Users:** Impacted specifically by pharmacy updates and Medicare Part B premium changes, as TRICARE acts as the second payer.

Common scenarios

**Scenario 1: Moving to the West Coast** In May 2026, SFC Miller transfers from Fort Liberty (East) to Fort Lewis (West). Under the current contract, the Miller family must now interface with **TriWest Healthcare Alliance** for all authorizations. Because they are in TRICARE Select, their 2026 deductible must be met before TRICARE pays its portion of civilian provider bills.

**Scenario 2: Managing Chronic Illness** Jane, a retired officer’s spouse, uses TRICARE Select. In 2026, she switched her daily maintenance medication from a retail pharmacy (CVs/Walgreens) to **Home Delivery via Express Scripts**. By doing so, she reduced her copay from roughly $50 per 90-day supply to approximately $34, saving her over $60 annually on a single prescription.

**Scenario 3: The 2026 Open Season** An E-6 family decides during the November 2025 Open Season to switch from Prime to Select for the 2026 plan year to gain more flexibility in choosing doctors without referrals. They are now navigating the 2026 "Group B" copayments, which include fixed dollar amounts for most primary care visits rather than a percentage of the allowable charge.

## Related terms * **T-5 Contract:** The fifth generation of TRICARE contracts which reorganized the regional management and provider networks. * **Qualifying Life Event (QLE):** An event like marriage, birth, or retirement that allows you to change your TRICARE plan outside of Open Season. * **Catastrophic Cap:** The maximum amount a family pays out-of-pocket for covered TRICARE services each calendar year. * **Express Scripts:** The company that manages the TRICARE pharmacy benefit. * **TRICARE Select:** A self-managed, preferred provider organization (PPO) plan.

## Sources * TRICARE Official Website: [https://www.tricare.mil](https://www.tricare.mil) * Defense Health Agency (DHA): [https://health.mil](https://health.mil) * TriWest Healthcare Alliance: [https://www.triwest.com](https://www.triwest.com) * Humana Military: [https://www.humanamilitary.com](https://www.humanamilitary.com)