US Family Health Plan (USFHP) Guide & Rates 2026
The **US Family Health Plan (USFHP)** is an additional TRICARE Prime option offered through private, non-profit community health care systems in six specific geographic regions of the United States. When you enroll in USFHP, you receive all your care—including primary care, specialty care, and prescriptions—from the local USFHP provider network instead of using military hospitals or the standard TRICARE retail pharmacy network.
*Note: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense. Visit TRICARE.mil for official policy information.*
Details
USFHP acts as a "wrap-around" managed care plan. If you live in a ZIP code served by one of the six designated USFHP providers, you can elect to enroll in this plan instead of TRICARE Prime or TRICARE Select.
### The Six Designated Providers To use USFHP, you must live in an area served by one of these specific networks: 1. **Johns Hopkins Medicine:** Serving Maryland, Washington D.C., and parts of Virginia, West Virginia, and Pennsylvania. 2. **Martin’s Point Health Care:** Serving Maine, New Hampshire, Vermont, and northeastern New York. 3. **Brighton Marine Health Center:** Serving Massachusetts, Rhode Island, and northern Connecticut. 4. **St. Vincent’s Public Health Strategy:** Serving Southeast Texas and Southwest Louisiana. 5. **Christus Health:** Serving Northeast Texas, Southeast Texas, and Southwest Louisiana. 6. **Pacific Medical Centers (PacMed):** Serving Western Washington state.
### Key Rules and Restrictions * **The "Lock-Out" Rule:** If you enroll in USFHP, you generally **cannot** get care at Military Treatment Facilities (MTFs) or use the Express Scripts mail-order pharmacy or TRICARE retail pharmacies. You must use the pharmacies provided by your specific USFHP health system. * **Primary Care Manager (PCM):** Like TRICARE Prime, you are assigned a PCM who coordinates your care and provides referrals for specialists. * **Pharmacy Benefit:** USFHP members use a separate pharmacy benefit managed by the designated provider, not the standard TRICARE/Express Scripts benefit.
### Costs (2026 Rates) Costs for USFHP mirror those of TRICARE Prime: * **Active Duty Family Members:** No enrollment fees and $0 out-of-pocket for covered services when coordinated by your PCM. * **Retirees and their families:** Annual enrollment fees apply. For 2026, these vary based on your "Group" (Initial enlistment date). Group A retirees typically pay approximately $392 per individual or $784 per family annually (estimated based on standard 2026 Prime adjustments; check with your specific USFHP provider for localized premium schedules). * **Copays:** Retirees and their families pay small copays for outpatient visits (e.g., ~$20–$30 per visit for 2026) and prescriptions.
## Who this affects * **Active Duty Family Members:** Ideal for those living away from military bases who want stable, civilian-style managed care. * **Retirees and their families:** Available to retirees under age 65. (Note: Once you become Medicare-eligible, you generally transition to TRICARE For Life and are no longer eligible for USFHP, with very few pre-existing exceptions). * **Survivors:** Eligible surviving family members can enroll. * **Activated National Guard/Reserve Families:** Eligible during the period of active duty service.
## Sources * **TRICARE.mil:** [US Family Health Plan Overview](https://www.tricare.mil/usfhp) * **US Family Health Plan National Site:** [usfhp.com](https://www.usfhp.com) * **Defense Health Agency (DHA):** [Benefit Descriptions](https://health.mil) * **Johns Hopkins USFHP:** [Member Resources](https://www.hopkinsmedicine.org/us-family-health-plan)