Non-Network Providers

Any TRICARE-authorized provider who hasn’t joined the network is a non-network provider. When you see a network provider, your provider will file claims for you. In most circumstances, you’ll pay less if you see a network provider instead of a non-network provider.

Find a Non-Network Provider

Your regional contractor has a list of non-network providers in each region who have filed claims with TRICARE.

• East Region non-network providers
• West Region non-network providers

If a provider listing doesn’t include a phone number, check your local telephone directory. 

When You’ll See a Non-Network Provider

You can see non-network providers when using TRICARE Select, TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult–Select. If enrolled in TRICARE Prime Remote, you’ll see non-network providers if there are no network providers available in your remote location.

If you’re enrolled in TRICARE Prime, you may see a non-network provider only if:

• You decide to use the point-of-service option, or
• Your regional contractor approves it because no other providers are available.

Participating vs. Nonparticipating Providers

There are two types of non-network providers: participating and nonparticipating. 

Participating Providers: Your Less Expensive Option 

Participating providers accept the TRICARE allowable charge as payment in full for their service. They’ll accept the payment directly from TRICARE. What does this mean for you?

• You only have to pay your cost-share when you visit the provider.
• The provider will collect the remaining amount directly from TRICARE.
• You won’t have to file claims.

Because participating providers are non-network and don’t have an agreement with TRICARE, they may participate on a case-by-case basis.

Nonparticipating Providers: Your Most Expensive Option 

Nonparticipating providers don’t accept the TRICARE allowable charge as the payment in full. They won’t normally file claims with TRICARE. What does this mean for you?

• You’ll probably have to pay the full amount to the provider and file a claim with TRICARE for a reimbursement (minus your cost-share).
• The provider has the legal right to charge up to 15% more than the TRICARE-allowable charge. Any charges above the allowable charge are your responsibility and won’t be reimbursed.