Network Providers
Any TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS that has signed a contract with your regional contractor is a network provider. Network providers:
- Accept a negotiated rate as payment in full
- File claims so you don’t have to
- Won’t ask you to sign any documents to make you pay amounts above your copaymentA fixed dollar amount you may pay for a covered health care service or drug. or cost-shareA percentage of the total cost of a covered health care service that you pay.. If this happens, contact your regional contractor or the Defense Health Agency TRICARE Health Plan Office.
Find a Network Provider
The regional contractors have established provider networks in each region.
What This Means for You
- You’ll pay less out-of-pocket.
- You’ll only have to pay your cost-share to the provider.
- Your provider will collect the rest of the amount directly from TRICARE.
When You’ll See Network Providers
If enrolled in TRICARE Prime or TRICARE Young Adult-Prime:
- Your primary care manager is a network provider if you aren’t enrolled at a military hospital or clinic.
- You’ll be referred to network providers for specialty careSpecialized medical/surgical diagnosis, treatment, or services a primary care provider isn’t qualified to provide. if you can’t be seen at a military hospital or clinic.
If enrolled TRICARE Prime Remote, you’ll see a network provider if there are any in your remote location.
If using TRICARE Select, TRICARE Reserve Select or TRICARE Retired Reserve, you’ll pay less for care received from network providers, but you aren’t required to use network providers.
Last Updated 11/21/2024