Changes

The Defense Health Agency awarded two new contracts to manage the TRICARE benefit for the East and West Regions, as shown on the map.

• Humana Military remains the regional contractor for the East Region.
• Six states formerly in the East Region moved to the West Region.
• TriWest Healthcare Alliance replaced Health Net Federal Services, LLC as the regional contractor for the West Region.

• Arkansas
• Illinois
• Louisiana
• Oklahoma
• Texas
• Wisconsin 

There are some small areas within Arkansas, Indiana, Missouri, and Wisconsin that will be exceptions to these region changes. These areas are called “carveouts.” They’re “carved out” from the rest of their state because they border another state with a nearby military hospital or clinic and are part of its Prime Service Area, where you may be eligible to get services.

A PSA is a geographical region (40 miles around a military hospital or clinic) where TRICARE Prime is available. These carveouts are part of PSAs retained under the Base Realignment and Closure program from the 1990s. These PSAs cross borders into a neighboring state. To maintain the integrity of these PSAs, these carveouts will be managed by the regional contractor of the region where the PSA is centered.

Check your state below to see if you live in one of these areas, and see what steps you may need to take.

East Region: If you live in the East Region, your scheduled care won’t be affected.

West Region: If you live in the West Region, your referrals and pre-authorizations issued before Jan. 1, 2025, are valid. If the provider named on the referral is:

• A TRICARE network provider: You can keep seeing your provider until the referral expiration date or September 30, 2025, whichever comes first. TRICARE Prime copayments apply.
• No longer a TRICARE network provider: You can keep seeing your provider and pay TRICARE Prime copayments. Starting Oct. 1, if the provider is still a non-network provider and isn’t named on the authorization, you’ll have to pay point-of-service fees. Make sure to get a new referral or authorization before the old one expires, or by October 1.

The DHA is working directly with TriWest to actively process all existing referrals.

If you live in the East Region, check the Humana Military provider directory. If you live in the new West Region, check the TriWest provider directory.

No. Your TRICARE copayments or cost-shares haven’t changed due to the new contracts. Your personal out-of-pocket costs depend on:

• Your TRICARE plan
• Whether your provider chooses to stay in the TRICARE network as a network, non-network/participating, or non-network/non-participating provider