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TRICARE Retiree Program Guide: Plans & 2026 Costs

Complete guide to 2026 TRICARE retiree benefits, including costs for Prime and Select, the 90-day enrollment window, and transitions to Medicare.

TRICARE Retiree Program Guide: Plans & 2026 Costs

*TRICARE.Com is an independent reference site and is not the official TRICARE program or a government entity. For official policy and the most current enrollment figures, visit [TRICARE.mil](https://www.tricare.mil).*

## Quick answer When you retire from active duty, your TRICARE coverage does not stay the same; you must take action to re-enroll in a retiree plan within 90 days of your retirement date. Most retirees choose between **TRICARE Prime** (managed care) or **TRICARE Select** (PPO-style), both of which require annual enrollment fees and higher cost-shares than you experienced while on active duty.

In detail

Retirement is a "Qualifying Life Event" (QLE). This means your active duty coverage (TRICARE Prime for ADSMs) ends on your final day of service. To avoid a gap in coverage, you must enroll in a retiree plan. If you miss the 90-day window, you can typically only enroll during the annual Fall Open Season.

### Available Plans for Retirees 1. **TRICARE Prime:** Similar to an HMO. You have a Primary Care Manager (PCM) and need referrals for specialty care. 2. **TRICARE Select:** A PPO-style plan. You can see any TRICARE-authorized provider without a referral, but you pay a deductible and cost-shares. 3. **TRICARE For Life (TFL):** For retirees age 65+ who have Medicare Part A and Part B. TFL acts as secondary payer to Medicare. 4. **US Family Health Plan (USFHP):** Available in six specific geographic areas through private, not-for-profit community healthcare systems.

### 2026 Costs and Fees Retiree costs are split into two groups based on when the sponsor joined the military. * **Group A:** Sponsor enlisted/commissioned before Jan. 1, 2018. * **Group B:** Sponsor enlisted/commissioned on or after Jan. 1, 2018.

| Feature (2026 Rates) | TRICARE Prime (Group A) | TRICARE Select (Group A) | | :--- | :--- | :--- | | **Annual Enrollment Fee** | ~$395 (Indiv) / ~$790 (Family) | ~$190 (Indiv) / ~$381 (Family) | | **Annual Deductible** | None (unless Point of Service) | $150 (Indiv) / $300 (Family) | | **Primary Care Visit** | $25 copay | $34 copay (In-network) | | **Specialty Care Visit** | $37 copay | $55 copay (In-network) | | **Catastrophic Cap** | $4,399 per year | $4,399 per year |

*Note: Group B retirees generally face higher enrollment fees and higher deductibles. All figures are estimates based on projected 2026 incremental adjustments; check TRICARE.mil for the final 2026 fee schedule.*

### Regional Management As of 2026, TRICARE is managed by two primary contractors under the T-5 contract: * **East Region:** Humana Military. * **West Region:** TriWest Healthcare Alliance. * **Pharmacy:** All plans use Express Scripts for retail and home delivery.

## Who this applies to * **Retired Active Duty Members:** Must enroll in Prime or Select and pay annual fees. * **Retired National Guard/Reserve (Gray Area):** These members are eligible for **TRICARE Retired Reserve (TRR)** until age 60. TRR has much higher monthly premiums because it is not government-subsidized. At age 60, they transition to standard retiree benefits. * **Medal of Honor Recipients:** Eligible for retiree-level benefits regardless of years of service. * **Family Members:** Spouses and children of the above categories are covered under the sponsor's retiree plan.

Common scenarios

### Scenario 1: The Young Retiree (Group A) John retires from the Army in 2026 after 20 years. He lives in the West Region (TriWest). He chooses **TRICARE Prime**. He must pay his first quarterly enrollment fee (roughly $197 for a family) immediately to start coverage. When his daughter sees a specialist, John pays a flat $37 copay because he obtained a referral from his PCM.

### Scenario 2: The "Gray Area" Reservist Sarah, a 45-year-old retired Reservist, isn't eligible for "regular" retiree TRICARE until she turns 60. She chooses **TRICARE Retired Reserve (TRR)**. In 2026, she pays a monthly premium (often exceeding $500 for individual coverage or $1,300+ for families) to maintain coverage until her 60th birthday.

### Scenario 3: The Medicare-Eligible Retiree Robert turns 65 in 2026. He is already enrolled in Medicare Part A and B. He automatically transitions to **TRICARE For Life**. He no longer pays TRICARE enrollment fees, though he must pay his Medicare Part B premiums. TRICARE now pays his remaining out-of-pocket costs for Medicare-covered services.

## Related terms * **Qualifying Life Event (QLE):** A certain change in your life, such as retirement, that allows you to enroll in or change TRICARE health plans outside of Open Season. * **Catastrophic Cap:** The maximum amount you or your family will pay out-of-pocket for covered TRICARE services each calendar year. * **Point of Service (POS) Option:** An expensive feature of TRICARE Prime that allows you to see any provider without a referral, but with a high deductible and 50% cost-share. * **DEERS:** The Defense Enrollment Eligibility Reporting System; the database that proves you are eligible for TRICARE. * **T-5 Contract:** The fifth generation of TRICARE managed care support contracts, which transitioned the West Region to TriWest Healthcare Alliance on Jan 1, 2025.

## Sources * TRICARE Official Site: [TRICARE.mil/Retiring](https://www.tricare.mil/retiring) * Defense Health Agency Cost Plans: [TRICARE.mil/costs](https://www.tricare.mil/costs) * Humana Military (East): [HumanaMilitary.com](https://www.humanamilitary.com) * TriWest Healthcare Alliance (West): [TriWest.com](https://www.triwest.com)