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2026 TRICARE Health Plan Costs Guide

Comprehensive 2026 TRICARE cost guide covering Prime, Select, and Pharmacy rates for Group A and B beneficiaries under TriWest and Humana Military.

2026 TRICARE Health Plan Costs Guide

*Disclaimer: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense or the official TRICARE program. For official policy and the most current data, visit TRICARE.mil.*

## Quick answer In 2026, your TRICARE costs depend on your plan type (Prime vs. Select), your sponsor’s military status, and when they joined the military (Group A vs. Group B). While active duty service members have $0 out-of-pocket costs, retirees and their families typically pay annual enrollment fees and cost-shares that vary based on whether they stay within the TRICARE network.

In detail

TRICARE costs are updated annually by the Defense Health Agency (DHA). To understand what you will pay in 2026, you must first identify your "Group."

* **Group A:** Sponsor’s initial enlistment or appointment was **before** Jan. 1, 2018. * **Group B:** Sponsor’s initial enlistment or appointment was **on or after** Jan. 1, 2018.

### 1. TRICARE Prime (Managed Care) Prime is the HMO-style option. For active duty families, there are no enrollment fees and no out-of-pocket costs for authorized care from a Primary Care Manager (PCM).

For **Retirees and their families** (Group A) in 2026: * **Annual Enrollment Fee:** 2026 rates vary — check TRICARE.mil for exact figures (typically ~$360–$720 depending on individual vs. family). * **Copayments:** Usually $20–$35 for specialty visits; $0 for preventative care. * **Point of Service (POS):** If you see a provider without a referral, you will pay a $300 deductible and 50% of the allowed charge.

### 2. TRICARE Select (PPO-style Care) Select allows you to see any TRICARE-authorized provider. You pay an annual deductible and then a percentage of the cost (cost-share).

**2026 Select Cost Estimates:** * **Deductibles:** Roughly $150–$200 for individuals; $300–$400 for families (varies by Group A vs. B). * **Catastrophic Cap:** This is the most you will pay out of pocket in a calendar year. For Group A retirees in 2026, this is approximately $4,000–$4,500.

### 3. Pharmacy Costs (Express Scripts) Pharmacy rates are standard across all TRICARE plans except for Active Duty Service Members (who pay $0). * **Military Pharmacy:** $0 for a 90-day supply. * **Home Delivery (Generic):** ~$13–$16 for a 90-day supply (2026 estimate). * **Retail Network (Generic):** ~$16–$20 for a 30-day supply (2026 estimate).

### 4. Regional Management As of 2025/2026, the regions are managed as follows: * **East Region:** Humana Military. * **West Region:** TriWest Healthcare Alliance.

## Who this applies to * **Active Duty Families:** Generally pay $0 for in-network care but may have small copays if using TRICARE Select. * **Retirees & Dependents:** Must pay annual enrollment fees for Prime and are subject to the annual catastrophic cap. * **TRICARE Reserve Select (TRS) Members:** Must pay monthly premiums regardless of Group A or B status. * **TRICARE For Life (TFL) Users:** Usually pay $0 out-of-pocket for TRICARE-covered services as long as Medicare pays first.

Common scenarios

**Scenario 1: The Active Duty Spouse** Jane is an active duty spouse in TRICARE Prime (West Region, TriWest). She sees her assigned PCM for an illness and is referred to a specialist. In 2026, her total out-of-pocket cost is **$0**, as all care was managed within the Prime network.

**Scenario 2: The Group A Retired Family** Mark retired in 2015. He and his wife use TRICARE Select. In January 2026, they must meet their **annual deductible** (approximately $300-$350 family total). After the deductible is met, Mark visits a network cardiologist. He pays a fixed copayment (roughly **$35-$50**), and TRICARE covers the remainder.

**Scenario 3: The Pharmacy User** Sarah needs a maintenance medication. She chooses Home Delivery via Express Scripts. For a 90-day supply of a brand-name formulary drug in 2026, she pays approximately **$38–$45**, saving her significantly compared to the retail pharmacy price.

## Related terms * **Catastrophic Cap:** The maximum out-of-pocket amount you pay each year for TRICARE-covered services. * **Cost-Share:** The percentage of the total cost of a covered health care service you pay (common in TRICARE Select). * **Enrollment Fee:** An annual fee paid by retirees and their families to remain enrolled in TRICARE Prime or Select. * **Network Provider:** A doctor or facility that has an agreement with Humana Military (East) or TriWest (West). * **Point of Service (POS) Option:** An additional cost incurred when a TRICARE Prime enrollee sees a provider without a referral.

## Sources * **TRICARE.mil Costs:** https://www.tricare.mil/costs * **Defense Health Agency (DHA):** https://health.mil/ * **Humana Military (East):** https://www.humanamilitary.com/ * **TriWest Healthcare Alliance (West):** https://www.triwest.com/