Spc. Chy Lee Ethridge, a pharmacy technician at Kimbrough Ambulatory Care Center, prepares medication requests at the Main Pharmacy for TRICARE beneficiaries on Fort Meade, Maryland, Feb. 12. (Defense Health Agency photo by Michelle Gonzalez) The appearance of U.S. Department of Defense (DoW) visual information does not imply or constitute DoW endorsement.
By: FEDweek StaffTRICARE Open Season 2025 is just around the corner, running from Nov. 10 to Dec. 9, and this is your once-a-year opportunity to review your health care coverage and decide if you’d like to make changes for the year ahead. Whether you’re enrolling for the first time or simply evaluating your current plan, taking a little time now can help ensure the right fit for you and your family when new coverage takes effect on Jan. 1, 2026.
TRICARE offers multiple health plan options, and the two most commonly used in the US are TRICARE Prime and TRICARE Select.
Prime functions more like an HMO, with lower out-of-pocket costs and care coordinated through your primary care manager—ideal for those comfortable with a structured care system.
TRICARE Select provides greater flexibility in choosing providers without needing referrals, though it typically comes with slightly higher costs. Overseas beneficiaries also have tailored Prime and Select options, and some regions offer the US Family Health Plan, providing care through community-based provider networks.
To compare plans, start with three easy tools: the TRICARE Plan Finder to see your eligibility, the Compare Plans Tool to review benefits side-by-side, and your 2025 cost information to understand expected expenses. If you’re also considering dental or vision coverage, remember that these come through FEDVIP during Federal Benefits Open Season, which ends one day earlier—Dec. 8.
The CY 2026 monthly premiums for TRICARE Reserve Select, TRICARE Retired Reserve, and TRICARE Young Adult and the quarterly premiums for Continued Health Care Benefit Program will be posted to the tricare.mil/changes web page once announced.
Some TRICARE premiums and copayments will increase in 2026, with pharmacy copayments rising for most US Family Health Plan members.
- Check your specific plan: Review your individual plan details for the most accurate information on any potential increases or changes to your monthly premiums or copayments.
- Compare plans: Use the BENEFEDS plan comparison tool to compare 2025 and 2026 pricing for your dental and vision plans to make an informed decision about whether to change plans or stay with your current one.
Source: https://www.federalregister.gov/documents/2025/10/28/2025-19672/tricare-notice-of-tricare-plan-program-changes-for-calendar-year-cy-2026?utm_source=chatgpt.com
What’s New for TRICARE in 2026
*Source: Federal Register notice on program changes for CY 2026
- Mail-Order Prescription Refills: Beneficiaries must now confirm refills before shipments are sent. Unconfirmed prescriptions will be paused but can be restarted anytime before expiration.
- No Cost-Share for Contraceptives: TRICARE-covered contraceptives under the pharmacy benefit now have $0 cost-sharing, improving access and affordability.
- Weight-Loss Drug Coverage (with Limits): Medications for treating obesity may be covered when medically necessary, prescribed by a TRICARE network provider, and part of a supervised treatment plan.
- Gender-Affirming Hormone Therapy Policy Change: TRICARE will no longer cover hormone therapy or puberty blockers for minors (18 and under), in accordance with FY 2025 NDAA provisions.
- Expanded Survivor Coverage for Reserve Families: Eligible surviving family members of Selected Reserve members enrolled in TRICARE Reserve Select may continue TRS or TYA coverage for up to three years after the service member’s death (beginning Oct. 1, 2025).
- Prime Enrollment Fee Clarification: The TRICARE Prime enrollment fee waiver now applies only to Group A Medicare-eligible retirees and their dependents. Group B beneficiaries must pay enrollment fees.
- No More Drive-Time Waiver: Prime enrollees who move within 100 miles of a military treatment facility may stay in Prime without requesting a waiver.
Expanded Medical Coverage: New or expanded coverage includes:
- Minimally invasive procedures for uterine fibroids
- Cryoablation for lung malignancies
- Basivertebral Nerve Ablation for chronic lower back pain
- Extended coverage for TENS devices for post-surgical pain
- Broadened preventive coverage, including new HPV testing options
- Faster access to cochlear implants for eligible children
- Expanded coverage of routine care in certain NIH-supported clinical trials
Even if you decide not to change your coverage, now is a great time to log in to milConnect and confirm your personal and family information is up to date. With healthcare needs and life circumstances constantly evolving, Open Season is your moment to make sure your plan still matches your lifestyle, budget, and health priorities.
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