TRICARE Published Half of Its 2027 Price List: Drug Copays Are Frozen by Law, the Rest Waits on the COLA

The Defense Health Agency published the TRICARE program changes for calendar year 2027 in the Federal Register on September 18, 2026 (document 2026-19115, 91 FR 59115). Settled: pharmacy copayments do not change on January 1, 2027, open season runs November 9 through December 8, 2026, Prime Service Areas are unchanged, and a list of new coverage takes effect. Not settled: every figure that scales with the retiree cost of living adjustment. Enrollment fees, deductibles, catastrophic caps and the premiums for TRICARE Reserve Select, Retired Reserve and Young Adult are absent from the notice, which says only that they will post to tricare.mil/changes before open season begins. That adjustment cannot be computed until the Bureau of Labor Statistics publishes the September Consumer Price Index on October 14, 2026.

What the notice actually settles

A final rule published February 15, 2019 (84 FR 4326) requires DHA to tell beneficiaries what is changing before each open season. The 2027 edition is short on money and long on coverage:

• Open season: November 9 through December 8, 2026 for Prime and Select. FEDVIP dental and vision closes a day earlier. Do nothing and your 2026 coverage carries into 2027.
• No Prime Service Area changes, and unlimited urgent care without a referral for Prime enrollees.
• A prescription copay waiver for Prime Remote families. Active duty family members in Prime Remote living more than 50 miles or a one hour drive from a military pharmacy pay $0 at retail network pharmacies, applied automatically since February 28, 2026.
• New coverage, including peripheral nerve stimulation for chronic and post-surgical pain. The Childbirth and Breastfeeding Support Demonstration, covering certified doulas and lactation consultants, runs through December 31, 2031.
• One thing went away. From July 1, 2026, transcutaneous electrical nerve stimulation devices are excluded except for acute post-operative pain.

The pharmacy freeze is law, not a favor

The notice says pharmacy copayments are unchanged for January 1, 2027. That is not a DHA decision to hold the line. 10 U.S.C. 1074g(a)(6)(A) prints a literal year by year table of cost-sharing amounts for 2018 through 2027, and the 2026 and 2027 rows are identical. The statute covers retail generic and formulary at 30 days and the three home delivery tiers at 90 days; the $85 retail non-formulary figure in the notice sits outside it. The last column below is ours: a family filling two generic maintenance drugs and one brand-name formulary drug by home delivery each quarter.

That family paid $152.00 in 2018 and pays $288.00 in 2027, a rise of 89 percent in nine years, written into the statute in advance. The same three drugs filled monthly at retail run $960.00 a year against $600.00 in 2018. Under subparagraph (C), survivors of members who died on active duty and chapter 61 disability retirees and their families still pay the 2017 amounts. Uniform formulary contraceptives are $0 under subparagraph (E), and active duty service members pay nothing anywhere.

What the published figures are worth, by rank

TRICARE prices are flat. Basic pay is not, so the same bill lands very differently by pay grade. The rows below are an active duty family on TRICARE Select in Group B, meaning an initial enlistment or appointment on or after January 1, 2018, which now covers most of the force. Basic pay comes from the 2026 DFAS tables in our own data; the other columns are DHA's published CY2026 figures. The deductible splits at E-4, the only place rank touches a TRICARE price directly.

A bad medical year costs an E-3 family 3.66 percent of basic pay and an O-5 family 0.97 percent, for identical care. The catastrophic cap is the ceiling on out-of-pocket costs for covered services in a calendar year, enrollment fees included and premiums excluded, so that column is a worst case rather than a typical one. Check your grade in the basic pay tables, and see where health care sits inside total compensation in the RMC calculator.

Group B is not simply worse, and that surprises people

The shorthand is that anyone who joined on or after January 1, 2018 pays more. On fixed costs that holds: the Group B family deductible for E-5 and above is $397 against $300, and the cap is $1,324 against $1,000. On per visit copays it runs the other way. A year of ordinary family care at the published CY2026 network rates:

Every line below moves with the COLA, and none of them are published

The notice is explicit about the mechanism: enrollment fees, premiums, catastrophic caps, deductibles and copayments are adjusted annually by federal law and regulation based on the cost of living adjustment applied to retired pay. Here is the CY2026 baseline the 2027 numbers will be built from.

Three Group A figures sit outside that mechanism: the $1,000 active duty family cap, the $3,000 retiree Prime cap, and the active duty family Select deductibles of $150 per person and $300 per family ($50 and $100 at E-4 and below). Those are dollar amounts written into 10 U.S.C. 1079 and 1086, not indexed figures, which is why they read the same on the 2026 fact sheet as they do in the statute.

Two of the three months that set that adjustment are published, which narrows it without settling it. The scale on the largest lines: an adjustment in the low three percent range is worth roughly $160 a year on the $4,635 Group B retiree catastrophic cap and about $40 on the $1,191 Group B retiree Select family fee. That is our arithmetic on published 2026 figures, not an announcement, and DHA rounds these into amounts that divide cleanly by month. The same adjustment raises retired pay, which the High-3 calculator prices, so the fee increase arrives alongside a larger gross payment.

What to do before December 8

1. 1Know which group you are in. Group A is an initial enlistment or appointment, yours or your sponsor's, before January 1, 2018. Group B is on or after. Anyone in Reserve Select, Retired Reserve or Young Adult-Select follows Group B rates regardless.
2. 2Put the real dates on the calendar. The notice gives the window as November 9 through December 8, 2026 and separately refers to November 10 as the start, so use November 9 and confirm on tricare.mil.
3. 3Wait for the fee tables before you switch plans. They post to tricare.mil/changes before open season opens. Choosing between Prime and Select on 2026 fee numbers is choosing on stale data.
4. 4Move maintenance drugs to home delivery. Two generics and a brand-name drug cost $288.00 a year by mail against $960.00 filled monthly at retail, both locked through 2027. Brand-name maintenance drugs can only be filled twice at retail anyway.
5. 5Check DEERS and your payment information. A stale address or a dead card on file is the ordinary way families end up with a coverage gap on January 1. The LES Auditor catches a wrong allowance on the pay side, and reserve members can weigh the $57.88 member and $286.66 family TRS premium against drill pay in the drill pay calculator.

The bottom line

The September 18 notice settles the coverage half of TRICARE 2027 and defers the money half. Pharmacy copayments hold at $16 and $48 retail and $14, $44 and $85 by mail because a statute wrote them down through 2027; a family with three maintenance prescriptions pays $288.00 by mail, up 89 percent since 2018 on a schedule set in advance. Enrollment fees, most deductibles and most catastrophic caps are indexed to the retiree cost of living adjustment and will not be published until after October 14; the Group A $1,000 and $3,000 caps are fixed by statute. On the last published figures a bad medical year costs an active duty Group B family $1,324, which is 3.66 percent of an E-3's basic pay and 0.97 percent of an O-5's. Rates shown are calendar-2026 figures published by the Defense Health Agency; always verify with your finance office before making financial decisions.