TRICARE East Region & Humana Military Guide (2026 Updates)
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## Quick answer Humana Military is the official regional contractor for the **TRICARE East Region**. They manage the provider network, process claims, and handle customer service for millions of beneficiaries across 32 states in the eastern U.S. If you live in the East Region, Humana Military is your point of contact for referrals, authorizations, and billing issues.
## In detail The TRICARE East Region is currently managed by Humana Government Business (Humana Military). Their role is central to how military families, retirees, and reservists access civilian healthcare.
### Geographic Coverage The East Region covers 32 states: Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (only the eastern portion), Vermont, Virginia, West Virginia, and Wisconsin.
### Humana Military Responsibilities As the regional contractor under the T-5 contract (which began full operations in 2025), Humana Military performs several critical functions: * **Provider Network:** They recruit and manage the "Network Providers" who accept TRICARE-negotiated rates. * **Referrals and Authorizations:** They review requests from Primary Care Managers (PCMs) to ensure specialty care is medically necessary. * **Claims Processing:** They pay civilian doctors for services rendered to TRICARE beneficiaries. * **Enrollment:** They process enrollment applications for TRICARE Prime, Select, and Young Adult plans.
### 2026 Costs and Fees Costs depend on the beneficiary’s "Group" (determined by when the sponsor joined the military) and their specific plan. Note: Active Duty Service Members (ADSMs) always have $0 out-of-pocket costs.
| Plan Type (Group A, 2026) | Annual Enrollment Fee | Primary Care Copay | Specialty Care Copay | | :--- | :--- | :--- | :--- | | **TRICARE Prime (Retirees)** | ~$391 (Indiv) / ~$782 (Family) | $27 | $44 | | **TRICARE Select (Retirees)** | ~$202 (Indiv) / ~$405 (Family) | $39 | $56 | | **TRICARE Select (Active Duty)** | $0 | $31 | $46 |
*Figures are estimates based on 2026 tier projections; check the Humana Military portal for exact person-specific rates.*
### Moving Between Regions If you move from the West Region (managed by **TriWest**) to the East Region, you must contact Humana Military to transfer your enrollment. Your medical records do not automatically transfer between contractors; you must coordinate with your new PCM.
## Who this applies to * **Active Duty Families:** Those living off-base in the East Region who use civilian doctors. * **Retirees and Their Families:** Individuals under age 65 living in the East Region who are not yet eligible for TRICARE For Life. * **National Guard and Reserve:** Members using TRICARE Reserve Select (TRS) while residing in an East Region state. * **Young Adults:** Adult children up to age 26 enrolled in TRICARE Young Adult (TYA) East.
Common scenarios
**1. The Specialist Referral (Prime)** An Army spouse in Georgia (Prime, Group A) sees their PCM for back pain. The PCM submits a referral for physical therapy. Humana Military reviews the request within 2–5 business days. Once approved, the spouse logs into the Humana Military portal to view the authorization letter and sees their copay will be $44 per visit (2026 rates).
**2. Seeking Urgent Care (Select)** A Navy retiree in Virginia (Select, Group A) gets a minor burn on a Saturday. Because they are on Select, they do not need a referral. They visit a local Humana-network urgent care center. The retiree pays a $39 copay (2026 rates) at the time of service, and the clinic bills Humana Military for the remainder.
**3. Relocating from California to Florida** An Air Force family moves from San Diego (West/TriWest) to Orlando (East/Humana). Upon arrival, they must contact Humana Military or use the Beneficiary Web Enrollment (BWE) tool to switch their region. If they don't, their claims in Florida will be denied because their "home" region is still listed as West.
## Related terms * **T-5 Contract:** The fifth generation of TRICARE managed care support contracts, which went live in early 2025. * **PCM (Primary Care Manager):** The doctor responsible for your basic care and for coordinating referrals through Humana. * **Network Provider:** A civilian doctor who has a contract with Humana Military to provide care at discounted rates. * **Beneficiary Web Enrollment (BWE):** The online portal used to update your plan or region via milConnect. * **Points of Service (POS) Option:** A feature of Prime that allows you to see any doctor without a referral, but at a much higher cost (typically a 50% cost-share).
## Sources * **TRICARE.mil - East Region:** https://www.tricare.mil/east * **Humana Military Official Site:** https://www.humanamilitary.com/ * **Defense Health Agency (DHA):** https://health.mil/ * **Express Scripts (Pharmacy):** https://www.express-scripts.com/tricare