Department of Defense (DoD) & TRICARE Healthcare Guide

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

## Quick answer The U.S. Department of Defense (DoD) is the federal executive department responsible for providing the military forces needed to deter war and protect the security of the United States. In the context of healthcare, the DoD operates the Military Health System (MHS), which manages TRICARE to provide health benefits to active duty service members, retirees, and their families.

In detail

The Department of Defense oversees one of the largest healthcare systems in the world. Its mission is two-fold: ensuring the "medical readiness" of the fighting force and providing a comprehensive health benefit to more than 9.6 million beneficiaries.

### The Military Health System (MHS) Structure The DoD administers healthcare through two primary channels: 1. **Direct Care:** Medical services provided at Military Medical Treatment Facilities (MTFs)—hospitals and clinics located on military installations. 2. **Purchased Care:** The TRICARE program, which uses private-sector civilian providers to supplement care when MTFs are unavailable.

### Oversight and Regional Contractors The Defense Health Agency (DHA) is the DoD component that manages TRICARE operations. As of 2026, the DoD manages this through two massive regional contracts (the T-5 contract): * **East Region:** Managed by **Humana Military**. * **West Region:** Managed by **TriWest Healthcare Alliance**. * **Pharmacy Program:** Managed by **Express Scripts**.

### Funding and Beneficiary Costs The DoD budget, authorized annually by Congress via the National Defense Authorization Act (NDAA), dictates TRICARE premiums and enrollment fees. For 2026, costs are categorized by the sponsor’s initial enlistment date:

### DoD vs. VA A common point of confusion is the difference between the DoD and the Department of Veterans Affairs (VA). * **DoD:** Manages TRICARE for active duty, their families, and military retirees. * **VA:** A separate cabinet-level department that manages healthcare specifically for veterans with service-connected disabilities or specific income requirements.

## Who this applies to * **Active Duty Service Members (ADSMs):** Mandatory enrollment in TRICARE Prime; the DoD covers 100% of healthcare costs. * **Active Duty Family Members (ADFMs):** Eligible for Prime or Select; the DoD subsidizes the vast majority of civilian care costs. * **Military Retirees:** Eligible for TRICARE Prime (if under 65) or TRICARE For Life (if 65+ and on Medicare). They pay annual enrollment fees to the DoD. * **National Guard and Reserve:** Eligible for TRICARE Reserve Select (TRS), a premium-based plan funded partially by the member and partially by the DoD.

Common scenarios

**1. The Active Duty Family** An Army Sergeant (E-5) is stationed at Fort Cavazos. Under DoD policy, the Sergeant has $0 healthcare costs. Their spouse and two children are enrolled in TRICARE Select. For 2026, they pay $0 in monthly premiums but have a small deductible (approx. $198 for the family) before the DoD begins paying for civilian office visits.

**2. The 2026 Retiree** A Navy Commander retires in April 2026 after 20 years of service. To keep TRICARE coverage, they must now pay an enrollment fee to the DoD (via Humana Military in the East Region). For 2026, this retiree (Group A) pays $786 per year for family coverage, a significantly lower rate than most private-sector employer plans.

**3. Pharmacy Benefits** A beneficiary fills a 90-day supply of a generic maintenance medication through Express Scripts Home Delivery. The DoD sets the 2026 copay for this at $16, leveraging its massive purchasing power to keep costs lower than retail pharmacy rates.

## Related terms * **Defense Health Agency (DHA):** The DoD agency that actually manages the TRICARE health program. * **Military Medical Treatment Facility (MTF):** A hospital or clinic owned and operated by the DoD. * **DEERS:** The Defense Enrollment Eligibility Reporting System; the DoD database that tracks who is eligible for TRICARE. * **T-5 Contract:** The 5th generation of TRICARE contracts that shifted West Region management to TriWest in 2025. * **NDAA:** National Defense Authorization Act; the annual law that sets military spending and health benefit rules.

## Sources * **TRICARE.mil:** [https://www.tricare.mil](https://www.tricare.mil) * **Health.mil (Official site of the MHS):** [https://health.mil](https://health.mil) * **Defense Health Agency:** [https://www.health.mil/About-MHS/OATMSO/Defense-Health-Agency](https://www.health.mil/About-MHS/OATMSO/Defense-Health-Agency) * **U.S. Department of Defense Official Site:** [https://www.defense.gov](https://www.defense.gov)