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US Family Health Plan: Guide to Coverage & Costs 2026

A complete guide to the US Family Health Plan (USFHP), including 2026 costs, participating providers, and how it differs from standard TRICARE Prime.

US Family Health Plan: Guide to Coverage & Costs 2026

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## Quick answer The US Family Health Plan (USFHP) is a TRICARE Prime option offered through private, non-profit community health care systems in six specific geographic regions of the United States. When you enroll in USFHP, you receive all your care—including primary care, specialty visits, and prescriptions—from that specific provider network instead of using military hospitals or the standard TRICARE network.

## In detail USFHP provides the same comprehensive coverage as TRICARE Prime, but it is managed by regional civilian healthcare networks rather than the Department of Defense regional contractors (Humana or TriWest).

### How it Works When you choose USFHP, you are assigned a Primary Care Manager (PCM) within the local USFHP network. You cannot use military hospitals or clinics for routine care, and you do not use the TRICARE pharmacy benefit (Express Scripts). Instead, you use the USFHP network’s pharmacies and their specific mail-order service.

### Participating Providers by Region As of 2026, there are six designated providers: * **Johns Hopkins Medicine:** Serving Maryland, DC, and parts of VA, WV, and PA. * **Martin’s Point Health Care:** Serving Maine, New Hampshire, Vermont, and northeastern New York. * **Brighton Marine Health Center:** Serving Massachusetts, Rhode Island, and parts of Northern Connecticut. * **St. Vincent’s Public Health Strategy:** Serving Southeast Louisiana and the Texas Gulf Coast. * **Christus Health:** Serving regions in Texas (San Antonio, Houston) and Louisiana. * **Pacific Northwest (PacMed):** Serving Western Washington and Northern Oregon.

### Costs and Fees (2026 Rates) Costs for USFHP mirror those of TRICARE Prime. * **Active Duty Family Members:** No enrollment fees and $0 out-of-pocket for covered services from network providers. * **Retirees and Families (Group A):** * Annual Enrollment Fee: Approximately $384 for an individual / $768 for a family (2026 estimated TRICARE Prime rates). * Copayments: $28 per primary care visit; $41 per specialty visit. * **Pharmacy:** Copays are generally aligned with TRICARE national rates, but you must use the USFHP-specific pharmacy system.

### Transition to T-5 Contract While the 2025 T-5 contract transition moved West Region management to TriWest Healthcare Alliance, USFHP exists as a separate statutory program. Enrollees in USFHP are NOT affected by the regional contractor shift because their care is managed entirely by their local USFHP designated provider.

## Who this applies to * **Active Duty Family Members:** Spouses and children living in a USFHP service area. * **Retirees and their families:** This includes those under age 65. * **Survivors:** Eligible family members of deceased service members. * **Medically Retired:** Service members and their families on the Permanent Disability Retirement List (PDRL). * **Exclusions:** TRICARE For Life (TFL) beneficiaries (those 65+ and Medicare-eligible) generally cannot enroll in USFHP, with very narrow exceptions for those grandfathered in before 2012.

Common scenarios

**The Retiree in Maine** John is a retired Navy Chief (Group A) living in Portland, Maine. He enrolls in the US Family Health Plan through Martin’s Point. In 2026, he pays his ~$384 annual enrollment fee. When he sees his Martin’s Point PCM for a cold, he pays $0. When he sees a specialist for his knee, he pays a $41 copay. He avoids military bases entirely for his healthcare.

**The Navy Spouse in Seattle** Sarah is an active duty spouse living in Seattle while her husband is deployed. She chooses USFHP via PacMed. Because she is an active duty family member, she pays $0 for her annual physical and $0 for her prescriptions, provided she uses the PacMed pharmacy network.

**The Relocating Family** A family moves from San Antonio, TX (Christus Health USFHP) to Florida. Because Florida does not have a USFHP designated provider, the family must disenroll from USFHP and switch to TRICARE Prime or Select managed by Humana Military (East Region).

## Related terms * **Designated Provider (DP):** The specific non-profit healthcare system authorized to provide USFHP services. * **Primary Care Manager (PCM):** The doctor you see first for all care; in USFHP, this must be a network-specific doctor. * **Group A:** Beneficiaries whose sponsor's initial enlistment or appointment began before January 1, 2018. * **Statutory Program:** A program established by federal law (USFHP was created by the National Defense Authorization Act). * **Point-of-Service (POS) Option:** An added cost for seeking care outside the USFHP network without a referral.

## Sources * **TRICARE.mil USFHP Overview:** https://www.tricare.mil/usfhp * **US Family Health Plan Alliance:** https://usfhp.com * **Defense Health Agency (DHA) Cost Sheets:** https://health.mil/Military-Health-Topics/Access-Cost-Quality/TRICARE/Cost-Shares * **Johns Hopkins USFHP Portal:** https://www.hopkinsusfhp.org/