Notice2026-19115
TRICARE: Notice of TRICARE Plan Program Changes for Calendar Year (CY) 2027
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
September 18, 2026
Issuing agencies
Defense Department
Abstract
This notice provides information regarding TRICARE Plan Program Changes for CY 2027.
Full Text
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<title>Federal Register, Volume 91 Issue 180 (Friday, September 18, 2026)</title>
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[Federal Register Volume 91, Number 180 (Friday, September 18, 2026)]
[Notices]
[Pages 59115-59117]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-19115]
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DEPARTMENT OF DEFENSE
Office of the Secretary
TRICARE: Notice of TRICARE Plan Program Changes for Calendar Year
(CY) 2027
AGENCY: Office of the Secretary of Defense, Department of Defense
(DoD).
ACTION: ACTION: Notice; TRICARE Plan Program changes for CY 2027.
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SUMMARY: This notice provides information regarding TRICARE Plan
Program Changes for CY 2027.
DATES: TRICARE Health Plan information in this notice is valid for
services during CY 2027 (January 1-December 31, 2027).
ADDRESSES: Defense Health Agency, TRICARE Health Plan Division, 7700
Arlington Boulevard, Suite 5101, Falls Church, Virginia 22042-5101.
FOR FURTHER INFORMATION CONTACT: Ms. Debra Fisher, 703-275-6224,
<a href="/cdn-cgi/l/email-protection#2e4a464f00404d5c00464b4f425a464d4f5c4b03415e5d00434c56005a465e035e4142474d57034f404a035e5c41495c4f435d034c5c4f404d466e464b4f425a4600434742">dha.ncr.healthcare-ops.mbx.thp-policy-and-programs-branch@health.mil</a>.
SUPPLEMENTARY INFORMATION: A final rule published in the Federal
Register (FR) on February 15, 2019 (84 FR 4326-4333) established the
requirement for the Director, Defense Health Agency (DHA), to provide
notice of TRICARE program changes to Military Health System (MHS)
beneficiaries each CY in connection with the annual open season
enrollment period. The following changes or improvements to the TRICARE
program benefits apply for CY 2027.
Open Season Announcement
Open Season is an annual period when beneficiaries may enroll in a
health plan or make changes to their health care, dental, and/or vision
coverage for the next CY.
During the TRICARE Open Season running from November 9 through
December 8, 2026, qualified MHS beneficiaries may enroll in or change
their TRICARE Prime or TRICARE Select plan.
During the Federal Employee Dental and Vision Insurance Program
(FEDVIP) Open Season running from November 9 through December 7, 2026,
qualified MHS beneficiaries, including TRICARE For Life beneficiaries,
may enroll in or make changes to their dental and/or vision plans.
FEDVIP is operated by the U.S. Office of Personnel Management.
Any changes MHS beneficiaries make during Open Season will take
effect on January 1, 2027. If a beneficiary remains eligible and does
not make any changes during Open Season, then his/her coverage will
remain the same for 2027. TRICARE enrollees can ensure they receive
important health plan information by promptly entering any change in
mailing address, email address, and other information in the Defense
Enrollment Eligibility Reporting System (DEERS) and verifying their
preference for receipt of information digitally or by paper mailings
with their respective regional contractors. TRICARE enrollees can avoid
any health care coverage gaps by ensuring changes in their payment
information are also updated with their regional contractors. See
<a href="https://tricare.mil/Plans/Eligibility/DEERS">https://tricare.mil/Plans/Eligibility/DEERS</a> as a guide for when to
update information in DEERS throughout the year.
Annual Announcements
The following TRICARE program features are subject to a year-to-
year determination and are announced each year prior to the annual
TRICARE Open Season:
[[Page 59116]]
Urgent Care Visits: The number of urgent care visits remains
unlimited without referrals for TRICARE Prime enrollees for Plan CY
2027. Beneficiaries may receive urgent care from TRICARE-authorized
urgent care centers (UCCs) and convenience clinics (CCs), either
network or non-network, without a referral. They may also receive
urgent care from any TRICARE network provider (i.e., family medicine;
internal medicine-general practice; pediatricians). In situations when
a TRICARE Prime enrollee seeks care from a non-network TRICARE
authorized provider (outside of a TRICARE-authorized UCC or CC), the
usual TRICARE Prime Point of Service deductible and cost-shares will
apply. Private sector care for active duty Service members is subject
to different rules. Covered beneficiaries in the U.S. who want
assistance with decisions on whether to seek urgent care, except those
enrolled in the Uniformed Services Family Health Plan (USFHP) or in a
plan under the Competitive Plans Demonstration (CPD), may call the MHS
Nurse Advice Line (NAL) at 1-800-874-2273 for health care guidance from
a specially trained registered nurse. The NAL is available 24/7 to
eligible TRICARE beneficiaries. USFHP and CPD enrollees should contact
their contractor's designated nurse advice line. Beneficiaries residing
overseas can call the NAL for health care advice when traveling in the
U.S. but must coordinate care with their Overseas Regional Call Center.
For additional information, call the servicing TRICARE contractor or
visit <a href="https://www.tricare.mil/ContactUs">https://www.tricare.mil/ContactUs</a> and click on ``MHS Nurse Advice
Line.''
Prime Service Area (PSA) Changes: PSAs are geographic areas around
military medical treatment facilities and Base Realignment and Closure
sites where TRICARE Prime is available. PSAs support the medical
readiness of active-duty members of the Uniformed Services by adding to
the capability and capacity of military hospitals and clinics. There
are no changes to the existing PSAs for CY 2027.
What's New
The following changes or improvements to TRICARE program benefits
apply to CY 2027 (although some changes were implemented in 2026):
Prescription Copay Waiver for Certain Dependents Enrolled in
TRICARE Prime Remote: Active-duty family members enrolled in TRICARE
Prime Remote in the United States and who live more than 50 miles or a
one-hour drive from a military medical treatment facility pharmacy will
no longer pay copayments for covered prescription medications filled at
retail network pharmacies, effective February 28, 2026. Eligible
families will see the copayment waiver applied automatically at the
pharmacy.
Demonstrations
Competitive Plans Demonstration: Again for 2027, TRICARE-eligible
active duty family members, retirees, and retiree family members who
reside within certain ZIP Codes in metro Atlanta, Georgia, and metro
Tampa, Florida, have additional options for their TRICARE coverage.
Eligible individuals in these areas may opt to voluntarily enroll in a
Competitive Plans Demonstration health plan, also known as TRICARE
Prime Demo, regardless of whether they are currently enrolled in
TRICARE Prime or TRICARE Select. See <a href="https://tricare.mil/Plans/HealthPlans/TRICARE-Prime-Demo">https://tricare.mil/Plans/HealthPlans/TRICARE-Prime-Demo</a> for more information. Details are
available in an April 28, 2025, Federal Register notice at <a href="https://www.federalregister.gov/documents/2025/04/28/2025-07258/tricare-tricare-competitive-plans-demonstration-cpd">https://www.federalregister.gov/documents/2025/04/28/2025-07258/tricare-tricare-competitive-plans-demonstration-cpd</a>.
Childbirth and Breastfeeding Support Demonstration (CBSD): The CBSD
was extended for five years and will now end on December 31, 2031.
Until the CBSD ends, beneficiaries may access the services of certified
labor doulas, certified lactation consultants, and certified lactation
counselors. The CBSD is available to beneficiaries in the United States
and overseas. Details are available at <a href="https://tricare.mil/cbsd">https://tricare.mil/cbsd</a>.
Pre-Hospital Blood Transfusions (PHBT) Demonstration: Beginning
January 1, 2027, a five-year nationwide demonstration will be used to
evaluate an alternative payment method for PHBT. This demonstration
will evaluate whether providing a supplementary reimbursement for PHBT
will improve beneficiary access to this life-saving care, enhance
clinical outcomes for patients in hemorrhagic shock, and prove to be
administratively feasible. Details are available in a July 6, 2026,
Federal Register notice at: <a href="https://www.federalregister.gov/documents/2026/07/06/2026-13515/tricare-demonstration-project-for-tricare-ambulance-add-on-reimbursement-for-pre-hospital-blood">https://www.federalregister.gov/documents/2026/07/06/2026-13515/tricare-demonstration-project-for-tricare-ambulance-add-on-reimbursement-for-pre-hospital-blood</a>.
Benefit Improvements
Ambulatory Blood Pressure Monitoring: TRICARE expanded coverage for
ambulatory blood pressure monitoring to include diagnosis of masked
hypertension in children and adults; diagnosis of abnormal nocturnal
blood pressure in children; and management of certain conditions as
recommended by the American Academy of Pediatrics or American Heart
Association.
Optune\TM\ Tumor Treating Fields (TTF) Device: Optune TTF device
for treatment of adult beneficiaries, 22 years of age or older, with
newly diagnosed glioblastoma multiforme, following surgery and
radiation is covered.
Ablative Fractional Laser (e.g., Carbon Dioxide and Erbium Yag):
Ablative fractional laser for the treatment of symptomatic scars
resulting from burns and other trauma is covered. Care must be
preauthorized, including subsequent sessions following the first
treatment to ensure ongoing therapy is medically necessary and
appropriate for the treatment of symptomatic scars. This treatment was
previously provided under Provisional Coverage and was converted to a
permanent benefit effective February 24, 2026.
Autologous Hematopoietic Stem Cell Transplantation: Benefits may be
cost-shared for a single event of myeloablative or non-myeloablative
therapy with autologous hematopoietic stem cell transplant for the
treatment of multiple sclerosis when criteria are met.
Stereotactic Laser Amygdalohippocampectomy (SLAH): SLAH including
magnetic resonance imaging guided laser interstitial thermal therapy
may be covered for the treatment of mesial temporal lobe epilepsy when
performed in accordance with American Society for Stereotactic and
Functional Neurosurgery recommendations.
Liver Transplant for Metastatic Colorectal Cancer: Liver
transplantation for colorectal cancer with liver metastasis is covered
for beneficiaries who meet specified inclusion requirements and do not
meet exclusion criteria, with prior authorization and tumor board
approval.
Peripheral Nerve Stimulation: Peripheral nerve stimulation, a non-
opioid, and minimally invasive pain treatment, for the treatment of
chronic pain, including chronic post-operative pain, chronic post-
amputation pain, chronic phantom limb pain, and chronic migraine and
headache conditions, is covered. Additionally, peripheral nerve
stimulation for the treatment of acute post-operative and acute post-
amputation pain for up to 60 days following surgery using temporary
peripheral nerve stimulations, such as SPRINT[supreg], is covered.
New Provisional Coverage
Vertebral Body Tethering: Vertebral body tethering, a minimally
invasive
[[Page 59117]]
alternative to spinal fusion therapy, is covered under the Provisional
Coverage Program for certain adolescents with adolescent idiopathic
scoliosis.
Benefit Changes
Transcutaneous Electrical Nerve Stimulation (TENS): Effective July
1, 2026, TENS devices and supplies are excluded for all conditions
except acute post-operative pain.
Appendix A
Certain TRICARE enrollee out-of-pocket costs (enrollment fees,
premiums, catastrophic caps, deductibles, and copayments) are adjusted
annually by Federal law and regulations based on the annual Cost of
Living Adjustment (COLA) applied to Uniformed Service member retired
pay. A difference in copayments remains between those who entered
Uniformed Service before January 1, 2018 (Group A), and those who
entered on or after that date (Group B).
The retiree COLA is typically announced after the Federal fiscal
year begins in October. Beneficiary out-of-pocket expenses impacted by
the 2026 COLA will be posted to the <a href="http://tricare.mil/changes">tricare.mil/changes</a> web page before
the start of TRICARE Open Season, November 10, 2026.
Premium Based Plans
The CY 2027 monthly premiums for TRICARE Reserve Select, TRICARE
Retired Reserve, and TRICARE Young Adult and the quarterly premiums for
the Continued Health Care Benefit Program will be posted to the
<a href="http://tricare.mil/changes">tricare.mil/changes</a> web page once announced.
Pharmacy Out-of-Pocket Expenses for CY 2027
TRICARE Pharmacy copayments are unchanged for January 1, 2027:
Pharmacy Copayments For Calendar Year 2027 *
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Retail network Retail network Mail order Mail order
generic brand-name Retail network generic brand-name Mail order non-
Year formulary 30- formulary 30- non-formulary formulary 90- formulary 90- formulary 90-
day supply day supply 30-day supply day supply day supply day supply
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2027.............................................. $16 $48 * * $85 $14 $44 $85
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* Active duty Service members (ADSMs) and Active duty family members enrolled in TRICARE Prime Remote enjoy a $0 copay for covered drugs at any
pharmacy.
* * For all beneficiaries except ADSMs, select brand-name maintenance medications (taken for long-term conditions) may only be filled twice at retail
and then must be filled through home delivery or military pharmacy.
Dated: September 15, 2026.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2026-19115 Filed 9-17-26; 8:45 am]
BILLING CODE 6001-FR-P
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This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.