TRICARE.com

TRICARE for Spouses: Benefits, Plans & 2026 Costs

Comprehensive guide to TRICARE benefits for military spouses, including 2026 plan options, regional contractors (Humana and TriWest), and cost structures.

TRICARE for Spouses: Benefits, Plans & 2026 Costs

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

## Quick answer As a spouse of an active duty, retired, or Guard/Reserve service member, you are eligible for comprehensive health and dental coverage through TRICARE. Your specific plan options and costs depend on your spouse’s military status and where you live, but you generally have the choice between managed care (TRICARE Prime) or a flexible PPO-style plan (TRICARE Select).

In detail

Spouses gain TRICARE eligibility through their sponsor (the service member). Eligibility begins on the date of marriage, provided the marriage is recorded in the **Defense Enrollment Eligibility Reporting System (DEERS)**.

TRICARE Plan Options for Spouses

* **TRICARE Prime:** A health maintenance organization (HMO) style plan. You are assigned a Primary Care Manager (PCM) who coordinates your care. There are no out-of-pocket costs for active duty spouses for covered services from network providers. * **TRICARE Select:** A preferred provider organization (PPO) style plan. You can see any TRICARE-authorized provider without a referral. This plan offers more flexibility but involves annual deductibles and cost-shares. * **TRICARE For Life (TFL):** If you are a spouse aged 65 or older and have Medicare Parts A and B, TFL acts as secondary payer to Medicare. * **TRICARE Young Adult:** If you are a former spouse or a dependent under age 26, this may apply under specific circumstances.

### 2026 Costs and Fees Costs are determined by the "Group" status of the sponsor. **Group A** sponsors entered service before Jan. 1, 2018. **Group B** sponsors entered service on or after that date.

| Benefit Category | Active Duty Spouse (Prime) | Retired Spouse (Select - Group A) | | :--- | :--- | :--- | | **Annual Enrollment** | $0 | ~$180 (Individual) / ~$360 (Family) | | **Deductible** | $0 | $150 (Individual) / $300 (Family) | | **Primary Care Visit** | $0 | ~$35-$40 | | **Specialty Care** | $0 | ~$50-$60 | | **Pharmacy (Generic)** | $0 (MTF) / $16 (Retail) | $0 (MTF) / $16 (Retail) |

*Note: 2026 rates are subject to annual adjustments; check TRICARE.mil for final verified figures.*

### Regional Management * **East Region:** Managed by **Humana Military**. * **West Region:** Managed by **TriWest Healthcare Alliance** (as of Jan 1, 2025). * **Pharmacy:** Managed by **Express Scripts**.

### Surviving Spouses If a sponsor dies on active duty, the spouse is covered as "transitional survivors" at active duty spouse rates for three years. After three years, they remain eligible at retiree spouse rates. If the sponsor was retired, the spouse remains eligible at retiree rates until/unless they remarry.

## Who this applies to * **Active Duty Spouses:** Eligible for TRICARE Prime (no cost) or Select (deductibles apply). * **Retired Spouses:** Eligible for Prime or Select with enrollment fees and cost-shares. * **Guard/Reserve Spouses:** Eligible for TRICARE Reserve Select (TRS) if the sponsor is in the Selected Reserve. * **Former Spouses:** May retain eligibility if they meet the "20/20/20" rule (married 20 years, sponsor served 20 years, 20-year overlap) and have not remarried. * **Same-Sex Spouses:** Fully eligible for all TRICARE benefits following the 2013 Supreme Court ruling.

Common scenarios

**The Mobile Active Duty Spouse** Sarah is married to an Army Sergeant in the East Region. She chooses **TRICARE Prime**. She visits a local military hospital for her annual checkup and a civilian network OBGYN for prenatal care. In 2026, her out-of-pocket cost for all covered medical care is **$0**.

**The Retired Couple** John retired from the Navy in 2015 (Group A). His wife, Linda, uses **TRICARE Select** in the West Region (TriWest). They pay an annual family enrollment fee of approximately **$360** (2026 rates) and a $300 deductible. When Linda sees her favorite civilian specialist, she pays a **25% cost-share** of the allowable charge.

**The Guard Spouse** Maria is married to a National Guard member on drill status. They pay a monthly premium of approximately **$50-$60** for TRICARE Reserve Select. When Maria goes to urgent care, she pays a small copay after meeting her deductible.

## Related terms * **DEERS:** The database (Defense Enrollment Eligibility Reporting System) that verifies your TRICARE eligibility. * **Qualifying Life Event (QLE):** An event like marriage or a move that allows you to change your TRICARE plan outside of open enrollment. * **Cost-Share:** The percentage of the total cost of a covered health care service you pay (post-deductible). * **MTF:** Military Treatment Facility; a military hospital or clinic located on a base. * **T-5 Contract:** The current 2025/2026 regional contract era which transitioned the West region to TriWest Healthcare Alliance.

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