By MOAA Staff

The new year will mark the launch of “T-5” – $136 billion worth of contracts with health care providers to manage the TRICARE program. Here’s how this changeover will affect beneficiaries, what actions you may need to take to ensure your coverage, and other details about 2025 TRICARE program updates, including costs and fees.

(Want more? MOAA’s TRICARE Guide includes detailed benefits explanations, a look at MOAA’s health care advocacy priorities, and exclusive resources for Life and Premium members.)

MOAA will monitor this rollout as part of its overarching priority to protect earned benefits for those who serve and have served, and their families. If you are experiencing TRICARE issues related to the changeover, reach out to us at legis@moaa.org; your feedback is critical as we shape our health care advocacy agenda in the new year with the 119th Congress.

How Will T-5 Change My Access to Care?

If you are living outside the U.S. or you use TRICARE For Life, you will not be affected by the changeover. If you are living in the TRICARE East Region, Humana Military will retain your regional contract. Those beneficiaries should see no changes brought on by T-5. However, your region may change based on your location.

Regardless of your location, the new year is a good time to confirm your contact information in the Defense Enrollment Eligibility Reporting System (DEERS): Inaccurate or outdated information may result in beneficiaries missing out on important TRICARE communications. Click here to learn how to check your DEERS record.

What Are the Regional Changes?

• Beneficiaries in Illinois, Louisiana, Oklahoma, and Texas will move from the East Region to the West Region in 2025.
• Arkansas and Wisconsin also will move from East to West, but some beneficiaries in those states may remain in the East.
• Indiana and Missouri will be split between regions.
• Unsure where you’ll end up? Go to TRICARE.mil/Changes and enter your ZIP code in the search field.

What About Those in the West Region?

TriWest replaces Health Net Federal Services as regional contractor on Jan. 1. Beneficiaries in the West Region should take these actions to ensure continuation of care:

• Payment: If you pay for your TRICARE coverage by military pay system allotment, no action is required. If you pay by bank transfer, credit card, or debit card, submit your payment details to TriWest before Jan. 1 using instructions on this website.
  
  
• Providers: Check the new West Region provider directory to determine whether your provider(s) remains in the network. Check frequently – new providers are being added daily.
  
  
• Prime: Primary Care Manger (PCM) assignments for TRICARE Prime members will be available via this online portal starting Jan. 1. As with the provider directory, new names are being added daily.

What About Referrals?

East Region referrals will not change. TriWest will honor unexpired referrals and preauthorizations from Health Net Federal Services until they expire or through June 30, 2025, whichever comes first.

Congress has directed TRICARE to provide Prime users who are making a PCS move with referrals for specialty care at their new duty station before leaving their current station. MOAA will monitor the contract changeover to ensure this requirement – a longstanding legislative priority for MOAA that was passed into law with the FY 2023 National Defense Authorization Act (NDAA) – is implemented with T-5.

What Are Other Concerns for Military Families?

Several children’s hospitals are not yet included in the West Region network. MOAA has expressed concerns about this development to TriWest and the Defense Health Agency. 

[RELATED: New TRICARE Rule May ‘Risk the Health of Military Kids’]

Providing “world-class” health care to military families must include access to children’s hospitals – indispensable regional providers of pediatric specialty care that treat the most complex pediatric cases. There is no substitute for much of this care within military treatment facilities (MTFs) or civilian general hospitals. 

What Will I Pay for My TRICARE Benefit in 2025?

• See 2025 costs and premiums at this link.
• Pharmacy costs will remain the same through Dec. 31, 2025.
• Get a full breakdown of costs by plan, including a plan comparison tool, at TRICARE.mil/Costs.

I Have More Questions

TRICARE’s website offers a “Call Us Wizard” designed to put you in touch with the resources you need. You can also connect with your contractor, US Family Health Plan provider, or other resources by using this TRICARE directory.

TRICARE also provides answers to frequently asked questions at this link.