TRICARE Retirement Guide: Changes and 2026 Costs
When you retire from active duty, your TRICARE coverage does not automatically continue; it ends on your retirement date. You have a **90-day window** (Qualifying Life Event) to enroll in a retiree health plan, or you will lose coverage entirely and may only be able to re-enroll during the next Open Season.
*Note: TRICARE.com is an independent reference site and is not part of the official TRICARE program or the Department of Defense. Visit [TRICARE.mil](https://www.tricare.mil) for official policy and enrollment.*
In detail
Retirement is classified as a **Qualifying Life Event (QLE)**. This means the status of you and your family members changes in the Defense Enrollment Eligibility Reporting System (DEERS) from "Active Duty" to "Retiree."
### 1. Update DEERS Immediately Before you can select a new plan, your personnel office must update your status in DEERS to "Retired." You cannot do this yourself, but you must verify that your contact information, address, and family status are correct.
### 2. Choose Your 2026 Plan Options Retirees generally choose between two primary paths:
* **TRICARE Prime:** Available in Prime Service Areas (PSAs). You have a Primary Care Manager (PCM) and need referrals for specialty care. * **TRICARE Select:** A self-referral, preferred provider organization (PPO) model. It offers more flexibility but generally higher out-of-pocket costs.
**Comparison for Retirees (2026 Plan Year - Group A)**
| Feature | TRICARE Prime (Retiree) | TRICARE Select (Retiree) | | :--- | :--- | :--- | | **Annual Enrollment Fee** | ~$380/individual; ~$760/family | ~$190/individual; ~$380/family | | **Annual Deductible** | None | $150/individual; $300/family | | **Primary Care Copay** | ~$25 per visit | ~$35 per visit | | **Specialty Care Copay** | ~$35 per visit | ~$50 per visit | | **Catastrophic Cap** | $4,170 per year | $4,370 per year |
*Note: Group A (Initial enlistment before Jan 1, 2018) and Group B (Initial enlistment on/after Jan 1, 2018) have different fee structures. Group B typically has higher enrollment fees but lower deductibles.*
### 3. Paying for Coverage Unlike active duty, where coverage is free, retirees must pay **monthly or quarterly enrollment fees**. * **Allotment:** Most retirees have their premiums deducted automatically from their retirement pay. * **Regional Contractors:** Benefits are managed by **Humana Military** in the East Region and **TriWest Healthcare Alliance** in the West Region.
### 4. Pharmacy and Dental * **Pharmacy:** Your pharmacy benefit continues via **Express Scripts**, but your copays will increase. Retail maintenance medications (long-term drugs) will eventually require the use of TRICARE Pharmacy Home Delivery. * **Dental/Vision:** TRICARE dental for active duty families ends. Retirees are eligible for the **Federal Employees Dental and Vision Insurance Program (FEDVIP)**, managed by OPM. You must enroll during the FEDVIP Open Season or within 60 days of retirement.
## Who this applies to * **Active Duty Service Members:** Moving to the retired list after 20+ years of service (or medical retirement). * **National Guard/Reserve:** "Gray Area" retirees (under age 60) typically use TRICARE Retired Reserve (TRR) until age 60, at which point they transition to standard retiree TRICARE. * **Family Members:** Spouses and children lose their "Active Duty Family Member" status and become "Retiree Family Members," which involves higher cost-sharing.
Common scenarios
**Scenario 1: The Prime Switch** Master Sergeant Miller retires in San Antonio (an East Region PSA). He chooses TRICARE Prime. In 2026, he sets up an allotment of approximately $63 per month from his retirement check to cover his family. He keeps a PCM at the local MTF but now pays a $25 copay for sick visits.
**Scenario 2: The Select Flexibility** Chief Petty Officer Jones retires in a rural area in the West Region. Because he is far from a base, he chooses TRICARE Select. In 2026, he pays a $380 annual enrollment fee. When he sees his local civilian doctor, he pays a $35 copay after meeting his $300 family deductible.
**Scenario 3: The FEDVIP Addition** Major Sarah Lee retires and realizes her TRICARE dental coverage has ended. Within 45 days of her retirement date, she visits the BENEFEDS website to enroll in a Delta Dental plan under FEDVIP so her children can continue getting orthodontic care.
## Related terms * **Qualifying Life Event (QLE):** A specific change (like retirement) that opens a 90-day window to change your TRICARE enrollment. * **DEERS:** The database that tracks your eligibility for military benefits. * **Catastrophic Cap:** The maximum amount you will pay out-of-pocket for covered services each year. * **Prime Service Area (PSA):** Geographic areas usually near military hospitals or clinics where TRICARE Prime is available. * **Allotment:** An automatic deduction from military retired pay used to pay TRICARE premiums.
## Sources * **TRICARE.mil Retirement Guide:** [https://www.tricare.mil/Retiring](https://www.tricare.mil/Retiring) * **Humana Military (East):** [https://www.humanamilitary.com/](https://www.humanamilitary.com/) * **TriWest Healthcare Alliance (West):** [https://www.triwest.com/](https://www.triwest.com/) * **BENEFEDS (Dental/Vision):** [https://www.benefeds.com/](https://www.benefeds.com/)