TRICARE West Region: TriWest Contractor Guide 2026
*Disclosure: TRICARE.com is an independent reference site and is not the official TRICARE program. For official policy and the most current government updates, visit TRICARE.mil.*
## Quick answer As of January 1, 2025, **TriWest Healthcare Alliance** is the sole managed care contractor for the TRICARE West Region. If you live in the western United States, TriWest is responsible for managing your provider network, processing referrals and authorizations, and handling your claims.
## In detail The TRICARE West Region 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 (specifically the El Paso area), Utah, Washington, and Wyoming.
Under the current "T-5" contract which began in 2025, TriWest replaced Health Net Federal Services (HNFS). This transition means all West Region beneficiaries now interact with TriWest for administrative health needs.
### Key Responsibilities of TriWest * **Network Management:** TriWest maintains the "TRICARE Network" of civilian doctors, specialists, and hospitals. * **Referrals & Authorizations:** If you are on TRICARE Prime, TriWest processes the requests from your Primary Care Manager (PCM) to see a specialist. * **Claims Processing:** TriWest handles the billing between your doctor and the government for services rendered in the West Region. * **Customer Service:** They operate the call centers for enrollment questions and billing disputes.
### 2026 Enrollment Costs (Select Plans) Costs are determined by the beneficiary's "Group" (Group A joined before Jan 1, 2018; Group B joined after). For 2026, many retirees and their families pay an annual enrollment fee to maintain coverage in the West Region.
| Plan Type | Group A (Retirees) 2026 Fee | Group B (Retirees) 2026 Fee | | :--- | :--- | :--- | | **TRICARE Prime (Individual)** | ~$392 | ~$532 | | **TRICARE Prime (Family)** | ~$784 | ~$1,065 | | **TRICARE Select (Individual)** | ~$189 | ~$590 | | **TRICARE Select (Family)** | ~$378 | ~$1,180 |
*Note: Active Duty Service Members (ADSMs) and Active Duty Family Members (ADFMs) on Prime plans generally have $0 enrollment fees. Costs are subject to annual adjustments; check TRICARE.mil for final 2026 updates.*
### The TriWest Provider Portal Beneficiaries in the West Region should create an account on the **TriWest self-service portal**. This allows you to: * Check the status of a referral. * View "Explanation of Benefits" (EOB) statements. * Change your Primary Care Manager (PCM). * Pay monthly premiums for plans like TRICARE Reserve Select (TRS).
## Who this applies to * **Active Duty Families in the West:** Those using TRICARE Prime or Select who need access to civilian specialists. * **Retirees and Families:** Those living in any of the 26 Western states who are not yet Medicare-eligible. * **National Guard and Reserve:** Members using TRICARE Reserve Select (TRS) who reside in the West Region. * **Providers:** Doctors and clinicians located in the West who want to participate in the military health system network.
Common scenarios
**1. Moving from East to West** Major Sarah J. moves from Fort Liberty (East Region/Humana) to Joint Base Lewis-McChord (West Region/TriWest) in March 2026. Her TRICARE Prime coverage must be transferred. She contacts TriWest to assign a new PCM at the Madigan Army Medical Center or a local civilian network clinic. There is no "break" in coverage, but her administrative file moves to TriWest’s system.
**2. Seeing a Specialist in Phoenix** Mark, a retired Petty Officer (Group A) on TRICARE Select, sees a network dermatologist in Phoenix for a skin check in 2026. Because he is in the West Region, the dermatologist submits the bill to TriWest. Mark pays a 2026 network copay (typically around $35–$40 for specialists) and TriWest pays the remainder of the allowable charge.
**3. Urgent Care Overseas** A West-enrolled beneficiary traveling in Germany needs care. While TriWest manages their home region, **International SOS** handles the overseas claim. However, once the traveler returns to their home in California, any follow-up care must be coordinated back through TriWest.
## Related terms * **T-5 Contract:** The fifth generation of TRICARE managed care contracts that transitioned the West Region to TriWest in 2025. * **PCM (Primary Care Manager):** The doctor responsible for your basic care and for initiating referrals through TriWest. * **Allowable Charge:** The maximum amount TRICARE/TriWest will pay for a specific medical service. * **East Region:** The other half of the U.S. TRICARE map, currently managed by Humana Military. * **Express Scripts:** The separate contractor that handles all TRICARE pharmacy benefits, regardless of region.
## 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/