TRICARE Team: Agencies and Contractors Guide

## Quick answer The TRICARE program is managed by the Defense Health Agency (DHA) and supported by a network of regional contractors including **Humana Military** (East), **TriWest Healthcare Alliance** (West), and **Express Scripts** (Pharmacy). While TRICARE.com is an independent reference site, this "team" of government agencies and private partners works together to provide health coverage to millions of service members and their families.

## In detail The TRICARE "Team" is a public-private partnership. The government sets the policy and funding, while private corporations handle the day-to-day claims processing, provider networking, and customer service. As of 2026, the key players in this ecosystem are:

### 1. The Defense Health Agency (DHA) The DHA is a joint, integrated combat support agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force. They oversee the entire TRICARE program from their headquarters in Falls Church, Virginia.

### 2. Regional Contractors (T-5 Contract) The United States is divided into two geographic regions. These contractors manage the provider networks and process your medical claims. * **TRICARE East:** Managed by **Humana Military**. Covering roughly 30 states in the Eastern U.S. * **TRICARE West:** Managed by **TriWest Healthcare Alliance**. TriWest took over the West region on January 1, 2025, replacing the previous contractor (Health Net Federal Services).

### 3. Specialty Contractors * **Pharmacy (TPharm5):** **Express Scripts** manages the TRICARE Pharmacy Home Delivery program and the retail pharmacy network. * **Dental:** Managed by **United Concordia** (for active duty dental and the TRICARE Dental Program) and **Benefeds/FEDVIP** (for retirees). * **Overseas:** Managed by **International SOS**, providing support for beneficiaries living outside the U.S.

### 4. Military Treatment Facilities (MTFs) These are the "bricks and mortar" hospitals and clinics located on military installations (e.g., Walter Reed, Brooke Army Medical Center). They are staffed by military and civilian personnel and serve as the primary source of care for TRICARE Prime enrollees.

Comparison Table: Regional Responsibilities (2026)

*Note: TRICARE.com is an independent reference site and is not a part of the official TRICARE program or the Department of Defense. For official policy, visit TRICARE.mil.*

## Who this applies to * **Active Duty Service Members (ADSMs):** Rely on the DHA and local MTFs for 100% of their care. * **Active Duty Family Members (ADFMs):** Interact with regional contractors (Humana or TriWest) for civilian provider referrals. * **Retirees & Families:** Use regional contractors for TRICARE Select or Prime management and Express Scripts for medications. * **National Guard & Reserve:** Use contractors to manage TRICARE Reserve Select (TRS) premiums and claims.

Common scenarios

### Scenario 1: Moving from East to West In 2026, Sgt. Jones moves from Fort Liberty (East) to Camp Pendleton (West). His "team" changes from **Humana Military** to **TriWest Healthcare Alliance**. He must update his address in DEERS and contact TriWest to enroll in a new Primary Care Manager (PCM).

### Scenario 2: Filling a Prescription Major Smith needs a maintenance medication. The "team" member involved here is **Express Scripts**. If she uses Home Delivery, her 2026 cost for a 90-day supply of a generic drug is typically **$16**, whereas a brand-name drug may cost **$43** (check TRICARE.mil for the most current pharmacy rate changes).

### Scenario 3: Seeking Specialty Care in the West A retiree in Arizona needs heart surgery. Because they are in the West Region, they (or their doctor) coordinate with **TriWest Healthcare Alliance** for the necessary prior authorizations to ensure the 2026 TRICARE Select deductible and cost-shares are applied correctly.

## Related terms * **DEERS:** The Defense Enrollment Eligibility Reporting System; the database that proves you are eligible for TRICARE. * **Contractor:** A private company (like Humana or TriWest) hired by the government to run TRICARE operations. * **MTF:** Military Treatment Facility; a clinic or hospital located on a military base. * **DHA:** Defense Health Agency; the government body that oversees the military health system. * **PCM:** Primary Care Manager; the specific doctor or clinic assigned to manage a Prime member's care.

## Sources * **TRICARE Official Site:** https://www.tricare.mil * **Humana Military (East):** https://www.humanamilitary.com * **TriWest Healthcare Alliance (West):** https://www.triwest.com * **Express Scripts (Pharmacy):** https://militaryrx.express-scripts.com