TRICARE West Region: TriWest Guide & 2026 Rates | TRICARE.com

The **TRICARE West Region** covers 26 states in the western United States and has been managed by **TriWest Healthcare Alliance** since January 1, 2025. Beneficiaries in this region coordinate their care, referrals, and claims through TriWest rather than the East Region’s contractor, Humana Military.

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## Quick answer The TRICARE West Region is the administrative area managed by TriWest Healthcare Alliance, covering the western half of the continental U.S., Alaska, and Hawaii. If you live in this region, TriWest handles your provider network, customer service, and claims processing.

In detail

### Geography of the West Region As of May 2026, the West Region includes the following 26 states: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas (excluding the areas around El Paso), Utah, Washington, Wisconsin, and Wyoming.

### The T5 Contract Shift Under the current T5 (fifth generation) contract, the West Region saw a major change on January 1, 2025: **TriWest Healthcare Alliance** replaced Health Net Federal Services (HNFS) as the regional contractor. This transition brought six states (Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin) into the West Region that were previously in the East.

### Network and Care Management * **TRICARE Prime:** In the West Region, Prime members must use the TriWest provider directory to find Primary Care Managers (PCMs). Referrals for specialty care are processed through TriWest. * **TRICARE Select:** Members have more flexibility to see any TRICARE-authorized provider, but they pay lower out-of-pocket costs when using TriWest network providers. * **Point of Service (POS):** Prime members who see a specialist in the West Region without a TriWest referral will face significant POS charges (typically a $300 individual deductible and 50% cost-shares).

### 2026 Fee Examples (Select/Network) Costs depend on the sponsor's enlistment date (Group A vs. Group B). * **Active Duty Family Member (Group A) Enrollment:** No annual fee. * **Retiree (Group A) Enrollment:** $194.04/individual or $388.08/family (2026 rates). * **Network Copay (Primary Care):** $25–$37 for retirees (2026 rates).

## Who this applies to * **Active Duty Service Members (ADSMs):** Stationed at bases in the West (e.g., JBLM, Camp Pendleton, Fort Bliss). They must enroll in TRICARE Prime or Prime Remote and use TriWest for specialty care referrals. * **Active Duty Family Members (ADFMs):** Residing in the 26 West Region states. They choose between TriWest’s Prime network or the Select plan. * **Retirees and their Families:** Living in the West Region. They must pay annual enrollment fees to TriWest for Prime or Select coverage. * **National Guard and Reserve:** Members using TRICARE Reserve Select (TRS) who live in the West Region manage their monthly premiums and claims through TriWest.

Common scenarios

### Moving from East to West Chief Petty Officer Smith transfers from Virginia (East) to California (West) in June 2026. Smith must contact TriWest to transfer his family's Prime enrollment. His "catastrophic cap" (the maximum out-of-pocket limit) transfers with him, so any money spent toward the $4,153 cap (2026 Group A retiree rate) in the East still counts in the West.

### Using a Specialist in Seattle A TRICARE Select beneficiary in Washington state needs a dermatologist. If they choose a provider in the TriWest Network, they might pay a $37 copay (2026 Retiree rate). If they choose a non-network authorized provider, they will likely pay 25% of the allowable charge plus any "balance billing" amounts.

### The El Paso Exception A Soldier stationed at Fort Bliss, Texas, is technically in the West Region, but because of the local healthcare market, certain administrative functions are tightly integrated with the local Military Treatment Facility (MTF). It is critical for those in border areas to verify their region via the TRICARE "Plan Finder" tool.

## Related terms * **TriWest Healthcare Alliance:** The private contractor responsible for administering TRICARE benefits in the West Region under the T5 contract. * **Regional Contractor:** The entity (TriWest in the West, Humana in the East) that manages the provider network and processes claims. * **PCM (Primary Care Manager):** The doctor or clinic responsible for your basic care and for coordinating referrals through TriWest. * **T5 Contract:** The current iteration of TRICARE's regional contracts which began full implementation in early 2025. * **DEERS:** The Defense Enrollment Eligibility Reporting System; you must update your address here before TriWest can process your Western Region enrollment.

## Sources * **TRICARE.mil - West Region:** https://www.tricare.mil/West * **TriWest Healthcare Alliance (Official Site):** https://www.triwest.com/ * **Defense Health Agency (DHA) T5 Announcement:** https://health.mil/About-MHS/OASDHA/Defense-Health-Agency/Operations/Business-Operations/Managed-Care-Support-Contracts/T-5 * **TRICARE.mil - Managed Care Support Contracts:** https://tricare.mil/About/MCSC