TRICARE Retiring Guide: Costs, Plans, and Deadlines (2026)

*Disclaimer: TRICARE.com is an independent reference site and is not the official TRICARE program or a government agency. For official policy and the most up-to-date program information, visit TRICARE.mil.*

## Quick answer When you retire from active duty, your TRICARE coverage does not automatically stay the same; you must take action to re-enroll within 90 days. You shift from "active duty" to "retiree" status, which typically introduces annual enrollment fees and higher cost-sharing for most plans.

In detail

Retirement is a **Qualifying Life Event (QLE)**. This means you have a 90-day window from your retirement date to choose a new plan. If you fail to enroll during this window, you will lose all TRICARE coverage and will only be eligible for care in a military hospital or clinic on a "space-available" basis.

### Plan Options for Retirees 1. **TRICARE Prime:** Available in Prime Service Areas (PSAs) in the U.S. You generally need to pay an annual enrollment fee. You still have a Primary Care Manager (PCM) and need referrals for specialty care. 2. **TRICARE Select:** A PPO-style plan that allows you to see any TRICARE-authorized provider. There are no referral requirements, but you will pay an enrollment fee and have higher out-of-pocket costs than Prime. 3. **TRICARE Select Overseas:** Available for retirees living abroad, though Prime is generally not available for retirees overseas (with very limited exceptions). 4. **US Family Health Plan (USFHP):** Available in six specific geographic regions through civilian healthcare systems.

### 2026 Costs and Fees In 2026, costs depend on whether you are in **Group A** (entered service before Jan. 1, 2018) or **Group B** (entered service on or after Jan. 1, 2018).

*Note: Group A retirees were previously exempt from Select enrollment fees, but as of 2021, all retirees pay enrollment fees unless they are a medically retired veteran or a survivor.*

### The Regional Transition As of 2025, the TRICARE West Region is managed by **TriWest Healthcare Alliance**, while the East Region remains with **Humana Military**. Ensure you contact the correct contractor for your new retirement residence.

### Pharmacy Benefits Your pharmacy coverage continues through **Express Scripts**. However, retirees pay higher copays for prescriptions filled at retail pharmacies or through home delivery than active duty families do. Using a military pharmacy remains $0 for most medications.

## Who this applies to * **Active Duty Retirees:** Those completing 20+ years of service. * **Medically Retired Service Members:** Those placed on the Permanent Disability Retired List (PDRL) or Temporary Disability Retired List (TDRL). * **National Guard/Reserve:** Members who reach "Gray Area" retirement (must use TRICARE Retired Reserve until age 60). * **Retiring Family Members:** Spouses and children of the above, who remain eligible for coverage until age 21 (or 23 if in college).

Common Scenarios

**The Prime Retiree (Group A):** Master Sergeant Miller retires in 2026 after 22 years. He lives near a military base in the East Region. He chooses TRICARE Prime. He pays approximately **$760 per year** (2026 rate) for his family's enrollment fee and continues to see a PCM at the base clinic with $0 copays for most visits.

**The Select Retiree (Group B):** Major Garcia retires in 2026. She joined the Army in 2019 (Group B). She wants to keep her civilian doctors and chooses TRICARE Select. She pays a higher annual enrollment fee (roughly **$1,200** for her family) plus a deductible and 20–25% cost-shares for her appointments.

**The Overseas Retiree:** Chief Petty Officer Smith retires and moves to Spain. He must enroll in TRICARE Select Overseas. He pays enrollment fees and must file claims for reimbursement for care received from Spanish providers, as there is no Prime option for retirees in his area.

## Related terms * **Qualifying Life Event (QLE):** A certain change in your life, such as retirement, that allows you to enroll in or change your TRICARE health plan outside of open enrollment. * **DEERS:** The Defense Enrollment Eligibility Reporting System; you must update your status here to "Retired" before you can enroll in a retiree plan. * **Catastrophic Cap:** The maximum amount you or your family pays out-of-pocket for covered medical services each calendar year. * **Primary Care Manager (PCM):** The doctor or clinic responsible for your basic care and referrals under a Prime plan. * **T-5 Contract:** The current TRICARE contract (effective 2025) that moved the West Region to TriWest Healthcare Alliance.

## Sources * TRICARE.mil Retiring Section: https://www.tricare.mil/lifeevents/retiring * Defense Health Agency Cost Plans: https://www.tricare.mil/costs * Humana Military (East): https://www.humanamilitary.com/ * TriWest Healthcare Alliance (West): https://www.triwest.com/