USFHP: US Family Health Plan Guide 2026
The US Family Health Plan (USFHP) is an additional TRICARE Prime option available through six specific non-profit civilian medical systems in certain regions of the United States. When you enroll in USFHP, you receive all your care—including primary care, specialty visits, and prescriptions—from that civilian network instead of using military hospitals or the standard TRICARE civilian network.
*Note: TRICARE.com is an independent reference site and is not affiliated with the Department of Defense. Visit TRICARE.mil for official government information.*
In detail
USFHP is a unique legacy program. While TRICARE usually divides the country into East and West regions managed by Humana and TriWest, USFHP operates as its own "mini-region" within specific geographic zones. If you enroll in USFHP, you effectively trade your access to Military Treatment Facilities (MTFs) for access to a high-quality civilian provider group.
### The Six USFHP Providers You must live in a specific zip code served by one of these six designated providers to enroll: 1. **Johns Hopkins Medicine:** Serving MD, DC, and parts of VA, PA, and WV. 2. **Martin’s Point Health Care:** Serving ME, NH, VT, and parts of NY and PA. 3. **Brighton Marine Health Center:** Serving MA, RI, and parts of CT. 4. **Saint Vincent Catholic Medical Centers:** Serving parts of NY, NJ, and PA. 5. **CHRISTUS Health:** Serving parts of TX and LA. 6. **Pacific Medical Centers (PacMed):** Serving Western WA.
### Key Rules and Features * **Exclusive Choice:** You cannot be enrolled in TRICARE Prime or TRICARE Select and USFHP at the same time. * **Pharmacy Access:** You must use the USFHP provider's pharmacy system. You **cannot** use the TRICARE Retail Pharmacy Program (Express Scripts) or military pharmacies. * **Referrals:** Your USFHP Primary Care Manager (PCM) handles all referrals for specialty care within their specific civilian network. * **Medicare Interaction:** If you are a retiree 65 or older, USFHP is one of the few ways to get "Prime-like" coverage even if you have Medicare Part B. However, once you enroll in USFHP, Medicare does not pay for your care; the USFHP provider does.
### 2026 Costs and Fees * **Active Duty Family Members:** No enrollment fees and $0 out-of-pocket for covered services (same as TRICARE Prime). * **Retirees and Families (Group A):** For 2026, enrollment fees are approximately $391.92 per individual or $783.84 per family (rates adjusted annually). * **Copayments:** Typical copays for retirees in 2026 include ~$20 for primary care visits and ~$37 for specialty visits.
## Who this applies to * **Active Duty Family Members (ADFMs):** Those living in a USFHP service area who prefer a civilian medical group over military base care. * **Retirees and their Families:** Including those under age 65 who want managed care. * **Retirees Age 65+:** This is a significant group, as USFHP allows seniors to maintain a "Prime" style of managed care rather than transitioning to TRICARE For Life. * **Transitional Assistance Management Program (TAMP) beneficiaries:** Those eligible for temporary coverage following separation.
*Note: Active duty service members themselves are NOT eligible for USFHP; they must remain in TRICARE Prime or Prime Remote.*
Common scenarios
### Scenario 1: The Retiree Over 65 Robert is 67 and lives in Seattle. Instead of using TRICARE For Life (TFL) and finding various doctors who take Medicare, he enrolls in the **Pacific Medical Centers (PacMed)** USFHP plan. He pays his annual 2026 enrollment fee (~$391). He sees his PacMed doctor for a $20 copay, and PacMed coordinates his entire heart health program. He does not use Express Scripts; he gets his pills via the PacMed mail-order pharmacy.
### Scenario 2: The Active Duty Spouse Sarah is married to an Army Sergeant stationed near Baltimore. They live off-base. Sarah opts for **Johns Hopkins USFHP** instead of TRICARE Prime. She pays $0 in enrollment fees and $0 for her doctor visits. Her children also see Johns Hopkins pediatricians. Because she is an ADFM, her costs remain at the same $0 threshold as standard Prime.
### Scenario 3: The Young Retiree Family Mark retired from the Navy at age 42 and lives in Portland, Maine. He enrolls his family in **Martin’s Point USFHP**. For 2026, he pays a family enrollment fee of ~$784. When his daughter needs a specialist, his Martin’s Point PCM provides a referral within their network, and Mark pays a $37 specialty copay.
## Related terms * **PCM (Primary Care Manager):** The lead doctor who coordinates all your care and provides referrals. * **MTF (Military Treatment Facility):** A clinic or hospital located on a military base; USFHP members generally cannot use these except for emergencies. * **Designated Provider:** The specific civilian healthcare organizations authorized by Congress to offer USFHP. * **T-5 Contract:** The latest TRICARE regional contract; while USFHP is separate, it operates alongside the T-5 systems (TriWest and Humana). * **Express Scripts:** The standard TRICARE pharmacy manager; notably **not** used by USFHP members.
## Sources * TRICARE Official USFHP Page: https://www.tricare.mil/usfhp * US Family Health Plan Alliance: https://usfhp.com * Johns Hopkins USFHP: https://www.hopkinsusfhp.org * Martin's Point USFHP: https://martinspoint.org/shop-for-a-plan/us-family-health-plan