TRICARE Cost-Sharing Changes in 2026 : Congressional Research Service (CRS) , November 17 , 2025
TRICARE Cost-Sharing Changes in 2026 : Congressional Research Service (CRS) , November 17 , 2025
From the report: “The Department of Defense (DOD), which is “using a secondary Department of War designation,” under Executive Order 14347 dated September 5, 2025, administers a statutory health entitlement (under Title 10, Chapter 55, of the U.S. Code) through the Military Health System (MHS). The MHS offers health care benefits and services through its TRICARE program to approximately 9.5 million beneficiaries that include servicemembers, military retirees, and family members. Health care services are available through DOD-operated hospitals and clinics, collectively referred to as military treatment facilities (MTFs), or through civilian health care providers participating in the TRICARE program. The Defense Health Agency (DHA) manages the TRICARE program.
With the exception of active duty servicemembers, beneficiaries are subject to certain cost-sharing requirements based on beneficiary category, health plan or benefit program, and the sponsor’s initial enlistment or appointment date. Beneficiary cost-sharing requirements include premiums or enrollment fees, deductibles, copayments, coinsurance, and a catastrophic cap. Periodically, DHA reviews and adjusts certain beneficiary cost-sharing amounts for the various TRICARE health plans and benefit programs based on statutory requirements or changes to coverage costs. This Insight reviews changes to TRICARE’s beneficiary cost-sharing amounts that are scheduled to take effect on January 1, 2026. These changes may generate constituent inquiries during the TRICARE open enrollment season from November 10, 2025, to December 9, 2025 (see below).”
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