Montaigne TRICARE: US Family Health Plan Guide
*Disclaimer: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense or the official TRICARE program. For official policy and the most current data, visit TRICARE.mil.*
## Quick answer Montaigne refers to **Montaigne Health**, an integrated healthcare delivery system in the Houston, Texas, area that specializes in the **TRICARE US Family Health Plan (USFHP)**. While most TRICARE beneficiaries use the East or West regional networks, those living in specific ZIP codes near Houston can choose Montaigne/USFHP as an alternative to TRICARE Prime, often receiving additional "wellness" benefits not found in standard military plans.
## In detail Montaigne Health is part of the US Family Health Plan (USFHP), a Department of Defense-sponsored program. Under this arrangement, Montaigne acts as the designated provider for beneficiaries in the **Texas Gulf Coast region**.
When you enroll in the US Family Health Plan through Montaigne, you agree to receive all your care—including primary care, specialty care, and pharmacy services—from Montaigne’s network of civilian providers rather than at a Military Medical Treatment Facility (MTF).
### How Montaigne/USFHP Differs from TRICARE Prime While Montaigne is officially a "Prime" option, it operates as a distinct HMO-style program.
* **Regional Management:** Unlike the standard TRICARE East region managed by Humana Military, the Montaigne USFHP is managed locally. * **Pharmacy Services:** You cannot use MTF pharmacies or the Express Scripts mail-order service. You must use Montaigne’s specific network of retail pharmacies and their mail-order system. * **Enhanced Benefits:** Montaigne often includes "value-added" benefits. For 2026, these typically include: * Annual physicals with zero copays. * Access to specific wellness programs and fitness incentives. * Discounted vision and hearing screenings.
### 2026 Costs and Enrollment The costs for Montaigne Health align with TRICARE Prime Group A and Group B rates.
| Category | Active Duty Family Members (ADFM) | Retirees & Families (Group A) | Retirees & Families (Group B) | | :--- | :--- | :--- | :--- | | **Annual Enrollment Fee** | $0 | ~$391.92 (2026 est.) | ~$519 (2026 est.) | | **Primary Care Visit** | $0 | $28 (2026 rate) | $22 (2026 rate) | | **Specialty Care Visit** | $0 | $41 (2026 rate) | $32 (2026 rate) | | **Emergency Room** | $0 | $84 (2026 rate) | $84 (2026 rate) |
*Note: Group A entered service before Jan 1, 2018; Group B entered after.*
### Geographic Coverage Montaigne serves the Houston area and surrounding counties. To enroll, you must reside in a specific ZIP code within their service area. If you move out of this area, you must disenroll and switch back to TRICARE Prime (East/West) or TRICARE Select.
## Who this applies to * **Active Duty Family Members:** Spouses and children living in the Houston/Gulf Coast area who prefer civilian doctors over military hospital care. * **Retirees and their Families:** Those under age 65 (not yet Medicare-eligible) who want a managed care option with lower out-of-pocket costs than TRICARE Select. * **TRICARE Young Adult (TYA) Members:** Eligible young adults living in the Houston area can choose the USFHP through Montaigne. * **Note:** Active duty service members themselves are generally **not** eligible for USFHP/Montaigne as they must remain under TRICARE Prime (and usually start at an MTF).
Common scenarios
**Scenario 1: The Local Houston Retiree** John is a retired Army Sergeant (Group A) living in Katy, TX. He chooses Montaigne for his 2026 coverage. He pays his annual enrollment fee of approximately $391.92. When he visits his Montaigne-network primary doctor, he pays a **$28 copay**. He cannot go to the pharmacy at Ellington Field; he must use the Montaigne mail-order pharmacy for his maintenance medications.
**Scenario 2: The Active Duty Spouse** Sarah is an active duty Navy spouse living in downtown Houston. She enrolls in the US Family Health Plan through Montaigne. For any prenatal visits or wellness exams in 2026, her **copay is $0**. Because she is an ADFM, she has no enrollment fee.
**Scenario 3: Turning 65** Mary has been using Montaigne for ten years. On her 65th birthday in 2026, she becomes eligible for Medicare. At this point, she is no longer eligible for Montaigne/USFHP and must transition to TRICARE For Life (TFL).
## Related terms * **US Family Health Plan (USFHP):** A TRICARE Prime option offered through large regional healthcare systems in six specific areas of the U.S. * **Designated Provider (DP):** The specific healthcare organization (like Montaigne) contracted to provide USFHP services. * **TRICARE Prime:** The managed care option that offers the lowest out-of-pocket costs but requires a Primary Care Manager (PCM). * **Primary Care Manager (PCM):** The doctor at Montaigne who coordinates all of your healthcare and referrals to specialists. * **Point-of-Service (POS) Option:** An additional cost incurred if a TRICARE Prime/USFHP member sees a specialist without a referral from their PCM.
## Sources * **TRICARE.mil - US Family Health Plan:** [https://www.tricare.mil/usfhp](https://www.tricare.mil/usfhp) * **USFHP Official Site:** [https://www.usfhp.com](https://www.usfhp.com) * **Montaigne Health (USFHP Texas):** [https://www.usfhp-gulfcoast.com](https://www.usfhp-gulfcoast.com) (Redirects to the Houston-area designated provider site)