TRICARE and Retirement: 2026 Costs, Plans, and Rules | TRICARE.com

*Disclaimer: TRICARE.com is an independent reference site and is not the official TRICARE program or the Defense Health Agency. For official policy and enrollment, visit TRICARE.mil.*

## Quick answer When you retire from active duty, your TRICARE coverage does not automatically continue; you must take action to re-enroll within 90 days of your retirement date. You will transition from "active duty" status to "retiree" status, which introduces annual enrollment fees and higher cost-shares for most plans.

In detail

Retirement is a Qualifying Life Event (QLE). This means you have a 90-day window starting from your retirement date to elect a new TRICARE plan. If you miss this window, you may lose coverage entirely until the next Open Season.

### Plan Options for Retirees As of 2026, retirees generally choose between two primary paths:

1. **TRICARE Prime:** Available in Prime Service Areas (PSAs). It offers the lowest out-of-pocket costs but requires you to use a Primary Care Manager (PCM) and obtain referrals for specialty care. 2. **TRICARE Select:** A self-managed, preferred provider organization (PPO) plan. You can see any TRICARE-authorized provider, but you will pay higher deductibles and cost-shares than Prime.

### 2026 Costs and Fees Costs are determined by your "Group" status. **Group A** includes those who entered service before January 1, 2018. **Group B** includes those who entered on or after that date.

| Fee Type (2026 Rates) | TRICARE Prime (Retiree) | TRICARE Select (Retiree) | | :--- | :--- | :--- | | **Annual Enrollment Fee** | ~$395 (Indiv) / ~$791 (Fam) | ~$190 (Indiv) / ~$381 (Fam) | | **Annual Deductible** | None | $150–$300+ (Varies by Group) | | **Catastrophic Cap** | $4,399 per year | $4,399 (Group A) / Higher for Group B |

*Note: Exact dollar amounts for 2026 are subject to annual adjustments; check TRICARE.mil for the final published index for your specific retirement month.*

### Pharmacy Benefits Retirees continue to use the **Express Scripts** pharmacy benefit. However, while active duty service members pay $0 for prescriptions, retirees pay copayments: * **Military Pharmacy:** $0 for a 90-day supply. * **TRICARE Pharmacy Home Delivery:** ~$15–$40 depending on drug tier (2026 rates). * **Retail Network Pharmacy:** ~$18–$50+ (2026 rates).

### Regional Management Your coverage is managed based on your geography: * **East Region:** Managed by **Humana Military**. * **West Region:** Managed by **TriWest Healthcare Alliance** (as of the T-5 contract transition). * **Overseas:** Managed by **International SOS**.

## Who this applies to * **Active Duty Retirees:** Those completing 20+ years of active service. You must enroll in Prime or Select. * **Retired Reserve (Gray Area):** National Guard or Reserve members who have retired but are not yet age 60. They are typically eligible for **TRICARE Retired Reserve (TRR)**, which has significantly higher monthly premiums. * **Medically Retired:** Service members placed on the Permanent Senior Disability Retired List (PDRL) or Temporary Disability Retired List (TDRL). They are treated as retirees regardless of years of service. * **Family Members:** Spouses and biological/adopted children remain eligible as long as the sponsor maintains retiree enrollment.

Common scenarios

**Scenario 1: The Prime Traditionalist** Master Sergeant Miller retires in San Antonio, TX (an East Region PSA) in 2026. He chooses TRICARE Prime for his family. He pays an annual enrollment fee of approximately $791. When he sees his PCM, his copay is $0, but when he is referred to a specialist, he pays a small fixed copay (roughly $37 in 2026).

**Scenario 2: The Select Specialist** Major Jones retires to a rural area in Montana (West Region, managed by TriWest) where no Prime Service Area exists. She enrolls in TRICARE Select. She pays an annual enrollment fee of approximately $381 for her family. She sees a local out-of-network doctor; she must first meet her $300 deductible, after which she pays a 25% cost-share for her visits.

**Scenario 3: The Gray Area Reservist** SFC Smith retires from the Army Reserve at age 45. He is not yet eligible for regular retiree TRICARE. He elects **TRICARE Retired Reserve (TRR)**. In 2026, his monthly premiums are approximately $600–$1,300 depending on family size. When he turns 60, he will transition to the standard retiree rates (Prime or Select).

## Related terms * **Qualifying Life Event (QLE):** A specific change (like retirement) that opens a 90-day window to change insurance plans outside of Open Season. * **Catastrophic Cap:** The maximum out-of-pocket amount you will pay each year for TRICARE-covered services. * **Prime Service Area (PSA):** Geographic areas usually surrounding military hospitals or clinics where TRICARE Prime is available. * **Group A vs. Group B:** Categories that determine your cost-sharing based on when you or your sponsor first joined the military. * **DEERS:** The Defense Enrollment Eligibility Reporting System; the database that proves you are eligible for military benefits.

## Sources * **TRICARE.mil - Retiring:** https://www.tricare.mil/LifeEvents/Retiring * **Humana Military (East Contractor):** https://www.humanamilitary.com/ * **TriWest Healthcare Alliance (West Contractor):** https://www.triwest.com/ * **TRICARE Costs (Official Guide):** https://www.tricare.mil/costs