TRICARE West Region Payment Crisis: What Happened, and What to Check Now

In 2025, TRICARE's West Region switched contractors, and the payment migration went badly. Thousands of retirees and reservists in the 26 West Region states were disenrolled, many without knowing it, because their recurring payment information never made it from Health Net to TriWest Healthcare Alliance. The final deadline to get payment information to TriWest was April 30, 2025, with disenrollments effective May 1 retroactive to each family's paid-through date, and a reinstatement window that closed June 30, 2025.

This article walks through what happened, who was affected, and what it cost the people who missed both dates. It matters in 2026 for one simple reason: TriWest still bills every fee-paying West Region beneficiary, and stale payment information (an expired card, a closed bank account) is still grounds for disenrollment for non-payment. The fix takes about 10 minutes a year.

Why the Deadlines Happened

On January 1, 2025, TRICARE's West Region got a new contractor. Health Net Federal Services, which had managed the region for years, lost the contract. TriWest Healthcare Alliance, a Phoenix-based nonprofit that already managed the VA's Community Care network, took over. That's a massive transition: about 4.6 million beneficiaries in 26 states, every enrollment record, every recurring payment, every referral, all migrating systems.

It did not go smoothly. Here's what happened:

• Many beneficiaries' payment information did not transfer automatically. Old HNFS records with bank routing numbers or credit cards did not all migrate to TriWest's systems.
• Some beneficiaries were told to re-enter payment info; others were told the transfer would be automatic. Neither was consistent.
• By May 2025, thousands had been disenrolled for non-payment, most without realizing anything was wrong until they tried to use their coverage.
• TriWest and the Defense Health Agency extended the payment deadline several times through early 2025 as the scale of the problem became clear.

The final version was firm: payment information had to reach TriWest by April 30, 2025. Beneficiaries who missed it were disenrolled May 1, and the reinstatement window closed on June 30, 2025. Anyone who missed both dates was left waiting for a Qualifying Life Event or the next Open Season to get back in. (A correction: an earlier version of this article presented those deadlines as April and June 2026. They were 2025 deadlines, and they have passed.)

Who TriWest Bills (The 26-State List)

The payment issue applies to you if both of these are true:

1. You live in a West Region state, and
2. You pay TRICARE enrollment fees or premiums (not everyone does).

The 26 West Region states

Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wisconsin, Wyoming.

If your state isn't listed, you're in the East Region and none of this applies to you. Humana Military, not TriWest, handles your account.

Who actually pays TRICARE fees

What You're Actually Paying (2026 Fees)

Fees depend on your group (based on when you or the sponsor first entered service) and your plan. Group A is anyone who entered service before January 1, 2018. Group B is anyone who entered on or after that date. Group B fees are slightly higher across the board.

Retiree annual enrollment fees, 2026

These are annual totals from the official TRICARE 2026 Costs and Fees sheet. Most retirees pay monthly (so Prime family Group A is roughly $63.75/month), though TriWest also lets you pay quarterly or annually. Monthly is the default. Group B pays noticeably more than Group A for Select in particular, $1,191 versus $375 for family coverage.

Monthly premium plans

TRS, TRR, and TYA are premium plans, not enrollment-fee plans. Their rates don't fit neatly in the table above, but they are all affected by the same TriWest deadline. 2026 monthly premiums:

• TRICARE Reserve Select (TRS): $57.88 member-only, $286.66 member and family.
• TRICARE Retired Reserve (TRR): $645.90 member-only, $1,548.30 member and family.
• TRICARE Young Adult (TYA) Prime: $794/month.
• TRICARE Young Adult (TYA) Select: $363/month.

If any of these charges stopped hitting your card or bank account at some point in 2025 or 2026 and you haven't noticed, check your enrollment status today. A silent stop in billing is exactly how the 2025 disenrollments snuck up on people.

How to Pay TriWest (4 Ways)

TriWest gives you four ways to submit payment. The online portal is fastest, the phone line is best if you don't have portal access or want to talk to a human, and the paper form is a fallback. Pick whatever you'll actually do.

Option 1: Online portal (fastest)

1. Go to tricare.triwest.com.
2. Log in using your primary email address on file with DEERS. If you're not sure which email is on file, check milConnect at milconnect.dmdc.osd.mil and update DEERS first if needed.
3. Select the beneficiary whose payment needs to be set up.
4. Choose your payment method: bank account (ACH) or credit/debit card (VISA, Mastercard, or Discover).
5. Pick a frequency: monthly, quarterly, or annual.
6. Submit. You'll get a confirmation email. Save it.

Option 2: Phone (888-TRIWEST)

Call 888-TRIWEST (888-874-9378). The automated system can take a one-time enrollment payment, and a live rep can help you set up recurring payments, change a card number, or confirm your status. Wait times have been longer than usual as the deadline approaches. Call in the morning (8 a.m. local) for the shortest hold.

Option 3: Mail a payment form

TriWest publishes two recurring payment forms. Fill out the one for your situation and mail it to the address on the form:

• Prime / Select / TRS / TRR recurring credit card or EFT form.
• TRICARE Young Adult recurring credit card or EFT form.

The forms are on tricare.triwest.com under Beneficiary Forms. Mail is the slowest option and was the one that burned people during the 2025 crunch, since forms that arrived after the deadline did not count. Portal or phone is safer if timing matters.

Option 4: MilConnect (enrollment changes only)

MilConnect can be used for enrollment changes, but it does not process TriWest payments. If you need to switch from Prime to Select, add a dependent, or change regions, use milConnect. For the actual payment, you still need the portal, phone, or mail.

How Retroactive Disenrollment Worked

On May 1, 2025, TriWest disenrolled beneficiaries whose payment information never arrived, along with their enrolled family members. That part was straightforward. The retroactive piece is what caught people off guard, and it is still how TRICARE disenrollment for non-payment works today.

Disenrollment is retroactive to your paid-through date. That's the last date your most recent successful payment covered you through. If your last payment covered you through March 31, your disenrollment is effective April 1. People whose payment info never migrated after the Health Net transition had paid nothing all year, so their disenrollment reached all the way back to January 1, 2025.

What retroactive disenrollment actually costs

Any care you or a family member received during the retroactive period, whether that's one visit or dozens, is treated as if you had no TRICARE coverage when it happened. You owe the full billed rate. Not the TRICARE-negotiated rate. The full billed rate. In 2025 that meant:

• Routine primary care visit: $150 to $350 out of pocket instead of a $26 Prime copay.
• Specialist visit: $300 to $600 instead of a $41 Prime copay.
• ER visit: $1,500 to $4,000+ instead of $108.
• Any surgery, imaging, or hospital stay during the gap: tens of thousands of dollars at billed rates.
• Prescriptions filled during the gap: beneficiaries could be billed back for the TRICARE-paid portion.

When you find out

Disenrolled beneficiaries typically found out one of three ways (and would again today):

1. A letter from TriWest (slowest).
2. A denied claim or bill from a provider showing you weren't covered for a recent visit (moderately fast).
3. Trying to get a prescription or schedule an appointment and being told you're not enrolled (fastest).

If you discover today that you're not enrolled when you think you are, call TriWest immediately. The 2025 reinstatement window is closed, but billing errors and recent lapses are handled case by case, and the sooner you call, the more options you have.

How Reinstatement Worked

For the 2025 transition, DHA opened one reinstatement window: May 1 through June 30, 2025. Here's how it worked, kept here both as the record and because the same mechanics (call, pay back fees, verify) apply to any non-payment disenrollment.

Step 1: Call 888-TRIWEST immediately

Call 888-TRIWEST (874-9378). Tell the rep: "I've been disenrolled from TRICARE and I'd like to reinstate." They'll look up your record and confirm your paid-through date.

Step 2: Provide current payment information

Give TriWest a working bank account or credit card. They'll set up your recurring payment going forward so you're not in this situation again.

Step 3: Pay all overdue fees back to January 1

This is the expensive part. TriWest calculates what you owe from your paid-through date (often January 1) through the current month. For a Group A Prime family that was a few hundred dollars due at once. For TRR member-and-family, four months of premiums ran north of $5,500 due at once.

You can usually pay this as a lump sum by credit card on the phone. Some beneficiaries have reported TriWest will work with you on a short payment plan, but don't count on it.

Step 4: Verify coverage was reinstated

Within a few business days, log into milConnect or call TriWest back. Confirm your plan shows as active and your effective date matches what you paid. Screenshot or save the confirmation.

Still Without Coverage? Your Two Paths Back

Anyone who missed both 2025 deadlines lost TRICARE medical coverage, and the same rules apply to any lapse today: you cannot simply call and re-enroll. TRICARE's enrollment rules require one of two triggers:

• Qualifying Life Event (QLE). Birth of a child, marriage, divorce, move to a new region, retirement, separation, gaining or losing other health coverage. A QLE opens a 90-day window to enroll.
• TRICARE Open Season. Runs mid-November to mid-December each year, with coverage starting January 1. For anyone still unenrolled from the 2025 mess, the November 2026 Open Season (coverage January 1, 2027) is the next scheduled way back in.

If you're healthy, young, and have other coverage (spouse's employer plan, for example), that might be survivable. For retirees with chronic conditions or family members mid-treatment, it's a significant problem. Six months without coverage can mean $50,000+ in self-paid care.

What about VA care?

If you have service-connected disabilities rated 0% or higher, you're eligible for VA healthcare as a separate track. VA care is free for service-connected conditions and low-cost for non-service-connected conditions depending on your priority group. It's not a full substitute for TRICARE (family members aren't covered at VA), but for the retiree personally it's a real backup. See our 2026 VA healthcare guide for current wait time data and how to get enrolled.

The Referral Waiver (Now Expired)

One piece of good news during the transition: DHA ran a Referral Approval Waiver, ultimately extended through June 30, 2025. While it lasted, enrolled TRICARE Prime beneficiaries in the West Region could see in-network specialists without waiting on TriWest's prior authorization.

Normally, Prime requires a referral from your primary care manager that TriWest then approves before you can see a specialist. During the transition, TriWest was slow on those approvals, so DHA waived the requirement. While the waiver ran:

• Your PCM could still refer you, but TriWest wouldn't hold up the visit waiting for approval.
• Enrolled Prime beneficiaries could go straight to a network specialist (cardiology, orthopedics, dermatology, etc.).
• Normal Prime copays still applied. The waiver was about approval, not cost.
• Out-of-network care still required authorization.
• Active duty service members were not included.

The waiver expired with the transition period. Standard referral rules are back in effect in the West Region: your PCM refers, TriWest approves, then you book the specialist.

The 10-Minute Payment Checkup

This is the part to actually do, today and then once a year (a good habit: every January when the new fees kick in). It takes about 10 minutes.

Frequently Asked Questions

I'm active duty. Does any of this affect me?

No. Active duty service members don't pay TRICARE enrollment fees. Your active duty family members on Prime or Select also don't pay fees. The payment issue is about fees and premiums, so only retirees (and Reserve/National Guard members on TRS or TRR) are affected.

I already pay TRICARE via monthly allotment from my retired pay. Am I affected?

Most likely no, but verify. Retirees who pay their TRICARE fees as a monthly allotment from DFAS retirement pay kept paying right through the 2025 transition. The people who got burned were those whose credit card or bank ACH payment did not transfer to TriWest. Log into milConnect and check that your TRICARE status shows "Enrolled" with a current paid-through date. If yes, you're fine.

I'm on TRICARE For Life. Do I need to do anything?

No. TFL has no enrollment fees. Your only ongoing cost is Medicare Part B, which you pay directly to Medicare, not TriWest. None of the TriWest payment issues apply to you.

I moved from an East Region state to a West Region state in 2025. Am I with TriWest now?

Yes, you should be. A move to a new region is a Qualifying Life Event that transfers your TRICARE enrollment to the new regional contractor. But the transfer does not automatically move your payment information. If you haven't set up a payment method with TriWest since you moved, do it today: portal or 888-TRIWEST. This exact gap is what disenrolled people in 2025.

What if I dispute the bill for care received during the retroactive period?

Reinstatement restores coverage retroactively to your paid-through date, so claims from the gap get reprocessed at TRICARE rates. If a provider billed you at non-TRICARE rates during a gap, contact them with a copy of your reinstatement letter and ask them to refile with TriWest. Most network providers will. If they've already sent you to collections, call TriWest's Beneficiary Services line and ask for a letter of reinstatement you can send to the provider and collection agency.

Could this happen again?

Yes. Any contractor change, billing system migration, or even a reissued credit card can quietly break a recurring payment. The defense is boring: confirm your payment method once a year, and glance at your statement monthly to see that the TRICARE charge actually posted. Ten minutes a year beats a five-figure retroactive bill.

Did any of this apply to East Region beneficiaries?

No. The East Region is managed by Humana Military and had no similar transition crisis. If your state is not on the 26-state West list above, this article is background reading only. Humana Military's normal payment processes apply as usual.

Use the Calculator to Plan Around This

TRICARE is one of the biggest post-retirement healthcare savings for military retirees, often worth $10,000 to $20,000 per year compared to civilian marketplace plans. Losing it for six months, even temporarily, can blow up a post-retirement budget. Use our calculator to model how TRICARE fits into your total retirement picture alongside your pension, VA disability, and civilian income.