TRICARE West Region & TriWest Guide 2026
The **West Region** is one of two primary TRICARE geographic areas in the United States, managed by the regional contractor **TriWest Healthcare Alliance**. As of January 1, 2025, TriWest took over all administrative and provider network duties for 26 states in the western U.S. under the T-5 contract.
*Note: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense or TRICARE.mil. For official policy, visit TRICARE.mil.*
In detail
The TRICARE West Region underwent a massive transition on January 1, 2025, when the Defense Health Agency (DHA) shifted management from Health Net Federal Services (HNFS) to **TriWest Healthcare Alliance**. This change was part of the "T-5" contract, designed to improve the provider network and streamline care for military families in the West.
### Geography of the West Region The West Region encompasses 26 states: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas (excludes areas near El Paso), Utah, Washington, Wisconsin, and Wyoming.
### TriWest’s Responsibilities TriWest acts as the "middleman" between the government and healthcare providers. Their core duties include: * **Provider Network Management:** Recruiting and maintaining a network of civilian doctors, specialists, and hospitals. * **Referrals and Authorizations:** Processing requests from Primary Care Managers (PCMs) to see specialists. * **Claims Processing:** Paying healthcare providers for covered services. * **Customer Service:** Operating call centers and "milConnect" portals for West Region beneficiaries.
### Key Plans Managed by TriWest The following 2026 plans are administered by TriWest in the West Region:
| Plan Name | Typical Cost Structure (2026) | Network Requirements | | :--- | :--- | :--- | | **TRICARE Prime** | $0 out-of-pocket for ADSMs/ADFMs | Must use PCM; requires referrals. | | **TRICARE Select** | Annual deductibles apply | No referrals; higher cost-share for out-of-network. | | **TRICARE Reserve Select** | Monthly premiums (e.g., ~$50-$250) | For qualified Selected Reserve members. | | **TRICARE for Life** | Secondary to Medicare | TriWest handles certain administrative coordination. |
### 2026 Costs and Enrollment Enrollment typically occurs during **Open Season** (late fall) for the following year. * **Prime Enrollments:** Active duty members have no enrollment fees. Retirees and their families (Group A) pay approximately $375–$750 annually (varies by plan year—check TRICARE.mil for current 2026 rates). * **Select Deductibles:** For an E-4 and below, the 2026 individual deductible is approximately $60–$125.
Who this applies to
* **Active Duty Service Members (ADSMs):** Stationed in the 26 Western states; must use TriWest’s network for any care received outside a Military Retirement Treatment Facility (MTF). * **Active Duty Family Members (ADFMs):** Living in the West Region; they choose between Prime (managed referrals via TriWest) or Select (freedom of choice within TriWest network). * **National Guard and Reserve:** Members living in the West who are enrolled in TRICARE Reserve Select (TRS) or TRICARE Retired Reserve (TRR). * **Retirees and Survivors:** Those under age 65 living in the West Region who are not yet eligible for Medicare/TRICARE for Life.
Common scenarios
### 1. Specialist Referral in Seattle An ADFM on **TRICARE Prime** in Washington needs to see a dermatologist. Their PCM at Madigan Army Medical Center submits a referral. **TriWest** processes this request and issues an authorization letter visible on the TriWest portal. The family pays **$0** as long as they see the TriWest-authorized specialist.
### 2. Emergency Room Visit in Phoenix A retiree on **TRICARE Select** goes to a local civilian ER in Arizona. Because they are on Select, they do not need a referral. TriWest processes the claim; the retiree pays a 2026 cost-share (approximately **$100–$250** depending on retiree status and Group category) after their deductible is met.
### 3. Moving from East to West A Soldier PCSes from Fort Liberty, NC (East Region/Humana) to Fort Carson, CO (West Region/TriWest). The Soldier must contact **TriWest** to transfer their enrollment. Their medical records remain in the MHS GENESIS system, but their civilian provider network and claims processing shift entirely to TriWest.
Related terms
* **T-5 Contract:** The fifth generation of TRICARE contracts which began full implementation on January 1, 2025. * **Primary Care Manager (PCM):** The doctor responsible for coordinating all care (required for Prime members). * **Network Provider:** A doctor or hospital that has a contract with TriWest to provide care at negotiated rates. * **Defense Health Agency (DHA):** The government body that oversees TRICARE and manages the regional contractors. * **Point of Service (POS):** An option for Prime members to see a non-network provider without a referral, resulting in significantly higher out-of-pocket costs.
Sources
* **TRICARE.mil West Region Page:** https://www.tricare.mil/West * **TriWest Healthcare Alliance Official Site:** https://www.triwest.com/ * **Defense Health Agency (DHA):** https://health.mil/ * **TRICARE Plan Finder:** https://www.tricare.mil/Plans/PlanFinder