Department of Defense (DoD) & TRICARE Guide 2026

*Disclaimer: TRICARE.com is an independent reference site and is not the official TRICARE program or the Department of Defense. Visit TRICARE.mil for official policy and information.*

## Quick answer The Department of Defense (DoD) is the executive department of the U.S. government responsible for providing the military forces needed to deter war and protect the security of the country. Within the DoD, the **Defense Health Agency (DHA)** manages the TRICARE program, providing healthcare to millions of service members, retirees, and their families through a combination of military hospitals and private sector networks.

In detail

As of 2026, the Department of Defense oversees one of the world's largest integrated healthcare systems. While the Secretary of Defense holds ultimate authority, the day-to-day administration of military health insurance (TRICARE) falls under the Assistant Secretary of Defense for Health Affairs and the Defense Health Agency (DHA).

### The Defense Health Agency (DHA) The DHA was established to unify the separate medical commands of the Army, Navy, and Air Force. Today, the DHA manages: * **Military Treatment Facilities (MTFs):** On-base hospitals and clinics. * **The TRICARE Health Plan:** The insurance-style benefit that allows beneficiaries to see civilian doctors. * **Pharmacy Program:** Managed by Express Scripts. * **Regional Contracts:** The DoD awards multi-billion dollar "T-5" contracts to private companies to manage regional networks. Currently, **Humana Military** manages the East Region and **TriWest Healthcare Alliance** manages the West Region.

### Budget and Costs The DoD budget for healthcare is determined annually by Congress through the National Defense Authorization Act (NDAA). This legislation sets the enrollment fees and catastrophic caps for beneficiaries.

### The Role of DEERS The DoD maintains the **Defense Enrollment Eligibility Reporting System (DEERS)**. This is the master database the DoD uses to determine who is eligible for TRICARE. If your information in the DoD's DEERS database is incorrect, your TRICARE coverage will be suspended or denied.

## Who this applies to * **Active Duty Service Members (ADSMs):** Required to enroll in TRICARE Prime; the DoD covers 100% of healthcare costs with no out-of-pocket fees. * **Active Duty Family Members (ADFMs):** Can choose between Prime (on-base/managed care) or Select (Preferred Provider Organization/PPO). * **Retirees and their Families:** Must pay annual enrollment fees to the DoD to maintain coverage until reaching age 65 (when they transition to TRICARE For Life). * **National Guard and Reserve:** Eligible for TRICARE Reserve Select (TRS), a premium-based plan funded partially by the DoD and partially by the member.

Common scenarios

**1. The Active Duty Transition** Staff Sergeant Miller is an active-duty soldier in the East Region. The DoD pays for 100% of his healthcare at an MTF managed by the DHA. When he moves to the West Region, his DEERS record is updated by the DoD, and his care management shifts from Humana Military to TriWest Healthcare Alliance.

**2. The 2026 Medical Retiree** A Petty Officer First Class retires in early 2026. To keep TRICARE Select coverage, they must set up an allotment from their DoD retired pay to cover the 2026 enrollment fee of $378.00 per year (for a family). If they fail to pay the DoD-mandated fee, they lose coverage.

**3. Pharmacy Benefits** A military spouse fills a maintenance medication at a retail pharmacy. Even though the pharmacy is a private business (e.g., CVS or Walgreens), the DoD’s contract with Express Scripts dictates that the spouse pays a $48 copay (2026 rate for brand-name drugs) for a 30-day supply.

## Related terms * **Defense Health Agency (DHA):** The DoD component that manages TRICARE and military hospitals. * **DEERS:** The database used by the DoD to verify healthcare eligibility. * **MTF (Military Treatment Facility):** An on-base hospital or clinic owned and operated by the DoD. * **T-5 Contract:** The current generation of DoD contracts with Humana and TriWest to provide provincial healthcare services. * **NDAA (National Defense Authorization Act):** The annual law passed by Congress that sets the DoD budget and TRICARE fee structures.

## Sources * **TRICARE.mil:** The official website for military health benefits. [https://www.tricare.mil](https://www.tricare.mil) * **Defense.gov:** The official website of the Department of Defense. [https://www.defense.gov](https://www.defense.gov) * **Health.mil:** The official site of the Military Health System and Defense Health Agency. [https://www.health.mil](https://www.health.mil)