Health Net Federal Services & TRICARE Guide

## Quick answer As of January 1, 2025, **Health Net Federal Services (HNFS) is no longer a TRICARE regional contractor.** They previously managed the TRICARE West Region, but that responsibility has transitioned to TriWest Healthcare Alliance under the current T-5 contract. If you are looking for current West Region authorizations, claims, or provider networks, you must now contact TriWest.

*Note: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense. For official policy, visit TRICARE.mil.*

## In detail For many years, Health Net Federal Services (a subsidiary of Centene Corporation) was the face of TRICARE in the western United States. However, the Department of Defense’s T-5 contract transition fundamentally changed the TRICARE landscape.

### The T-5 Transition (Effective Jan 1, 2025) The Defense Health Agency (DHA) awarded the fifth generation of TRICARE contracts (T-5) to streamline operations. Under this shift: * **The West Region:** Managed by **TriWest Healthcare Alliance**. They replaced HNFS. * **The East Region:** Remains managed by **Humana Military**. * **The Geography:** Six states (Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin) shifted from the East Region to the West Region to balance beneficiary populations.

### What happened to HNFS claims and records? While HNFS no longer manages the West Region, they are responsible for "winding down" operations for services rendered prior to January 1, 2025. * **Claims for 2024 and earlier:** If you have an outstanding claim for medical services provided on or before December 31, 2024, those were processed by Health Net. * **Appeals:** Any appeals for care received during the HNFS contract period must follow the specific transition guidelines provided during the 2025 hand-off. * **Current Care:** For any care received in 2025 or 2026, HNFS has no involvement. You must use the TriWest (West) or Humana Military (East) portals.

## Who this applies to * **Former West Region Beneficiaries:** Anyone who lived in the West Region prior to 2025 and is looking for historical claims or tax documents (1095-B forms) related to the HNFS era. * **Providers:** Doctors and facilities who were in the HNFS network must ensure they are now credentialed with TriWest to remain "in-network" for TRICARE Prime or Select. * **Active Duty & Retirees in the West:** Residents of Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming (plus the six transfer states).

Common scenarios

**Checking an old 2024 Claim** Jane, a TRICARE Select beneficiary in California, had surgery in November 2024. She noticed a discrepancy in her 2026 tax records regarding her 2024 out-of-pocket costs. Because the service occurred before the T-5 transition, she (or her provider) must reference documents originally issued by Health Net Federal Services, though the TriWest transition portal may provide legacy links.

**New Referrals in 2026** Mark, an Active Duty soldier in Texas (now part of the West Region), needs a physical therapy referral in May 2026. Even though Texas was formerly East Region and the West was formerly HNFS, Mark ignores both. He must coordinate through his Primary Care Manager (PCM) and TriWest to ensure his $0 copay (Active Duty) is maintained.

**Pharmacy Costs** Regardless of the HNFS to TriWest transition, pharmacy costs remain standardized. In 2026, for a 90-day supply of a brand-name maintenance drug via Express Scripts home delivery, most retirees pay a set copay (varies by plan year—check TRICARE.mil for current rates). HNFS never managed the pharmacy benefit.

## Related terms * **T-5 Contract:** The fifth generation of TRICARE managed care support contracts that began full implementation in 2025. * **TriWest Healthcare Alliance:** The current contractor for the TRICARE West Region. * **Humana Military:** The current contractor for the TRICARE East Region. * **Managed Care Support Contractor (MCSC):** The private companies (like HNFS, TriWest, or Humana) that handle the administration of TRICARE benefits. * **Regional Transition:** The process of moving beneficiary data and provider networks from one contractor to another.

## Sources * **TRICARE.mil Transition Page:** https://www.tricare.mil/t5 * **TriWest Healthcare Alliance:** https://www.triwest.com/ * **Defense Health Agency (DHA):** https://health.mil/