TRICARE Post Retirement: 2026 Guide to Costs & Plans

*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 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 Family Member" status to "Retiree and Family Member" status, which introduces annual enrollment fees and higher cost-shares for most plans.

## In detail Retirement (including being placed on the Permanent Early Retirement List or Temporary Early Retirement List) is a **Qualifying Life Event (QLE)**. This means you have a 90-day window from your retirement date to elect your new coverage. If you miss this window, you may lose coverage entirely until the next Open Season.

### Available Plan Options Most retirees choose between these two primary options:

* **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. * **TRICARE Select:** A PPO-style plan available worldwide. It does not require a PCM or referrals, offering more flexibility at the cost of higher deductibles and cost-shares.

### 2026 Costs (Group A vs. Group B) Costs are determined by when you or your sponsor first joined the military. * **Group A:** Initial enlistment or appointment was before Jan. 1, 2018. * **Group B:** Initial enlistment or appointment was on or after Jan. 1, 2018.

*Note: Group B retirees typically face higher enrollment fees (e.g., ~$575+ for Individual Prime) and higher deductibles. All figures are estimates based on 2026 projections; check TRICARE.mil for exact tiered increases.*

### Regional Contractors As of 2026, your coverage is managed based on your residence: * **TRICARE East:** Managed by **Humana Military**. * **TRICARE West:** Managed by **TriWest Healthcare Alliance** (under the T-5 contract). * **Overseas:** Managed by **International SOS**.

### Pharmacy Benefits Retirees continue to use the **Express Scripts** pharmacy benefit. However, cost-shares for maintenance medications are significantly higher at retail pharmacies compared to Military Pharmacies (MTFs) or Home Delivery. Generic medications via Home Delivery remain the most cost-effective option for retirees.

## Who this applies to * **Retiring Active Duty Service Members:** Must switch from TRICARE Prime (Active Duty) to a retiree plan. * **National Guard/Reserve:** Members retiring at age 60 (or earlier with qualifying service) transition from TRICARE Retired Reserve (TRR) to TRICARE Prime or Select. * **Medically Retired Members:** Those placed on the TDRL or PDRL qualify for retiree benefits regardless of years of service. * **Family Members:** Spouses and children of retirees are covered, but their status changes from "Active Duty Family Member" to "Retiree Family Member," impacting their copay amounts.

Common scenarios

**Scenario 1: The Group A Prime User** Master Sergeant Smith retires in June 2026 after 22 years of service. Since he enlisted in 2004 (Group A) and lives near a military base in the East Region, he chooses **TRICARE Prime**. He pays an annual enrollment fee of approximately $782 for his family. When his spouse sees a civilian specialist with a referral, they pay a $41 copay (2026 rate).

**Scenario 2: The Group B Select User** Major Jones retires in 2026 having joined in 2018 (Group B). She moves to a rural area without a Prime Service Area and chooses **TRICARE Select**. She pays an annual enrollment fee of roughly $600 for her family. Because she is Group B, her network primary care visits cost about $40, and she must meet a $400+ family deductible before TRICARE begins cost-sharing.

## 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. * **Group A/B:** The classification system that determines your fee structure based on your military entry date. * **Catastrophic Cap:** The maximum out-of-pocket amount you will pay for covered services each calendar year. * **Prime Service Area (PSA):** Geographic areas where TRICARE Prime is offered, usually near military hospitals or clinics. * **DEERS:** The Defense Enrollment Eligibility Reporting System; the database that must be updated immediately upon retirement to reflect your new status.

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