Referrals and Pre-Authorizations

A referral is when your primary care manager or provider sends you to another provider for care that they don’t provide.

An authorization is when TriWest Healthcare Alliance approves your care before you go to your appointment. When referred, your provider will get you a referral and pre-authorization (if required) at the same time. You’ll receive an authorization letter from TriWest letting you know what steps to take next.

Does my service require a referral or pre-authorization?

Use the TriWest Referral and Authorization Decision Support tool to learn if you need a referral. Log in to the West Region beneficiary portal now and access the tool to manage your care.

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How can I view my referrals and pre-authorizations?

Log into the beneficiary self-service portal. On the portal, you can:

• Use the Referral and Authorization Decision Support tool to see if a referral is required for the care you're seeking.
• Review active referrals and authorizations.
• Enroll in a clinical care support program.
• View your eligibility and enrollment information.
• Find a network provider for your care.
• And more!

Log in or Sign Up as New User

What provider can I go to?

I'm a TRICARE Prime enrollee.

If the provider on your referral is:

• A TRICARE network provider, you can keep seeing your provider until the referral ends or Sept. 30, 2025, whichever comes first. TRICARE Prime copayments apply. 
• No longer a TRICARE network provider, you can keep seeing your provider and pay TRICARE Prime copayments. Starting Oct. 1, 2025, if the provider is still a non-network provider, and is not named on the referral, you'll have to pay point-of-service fees. Make sure to get a new referral before the old one expires, or by Oct. 1, 2025.

I'm a TRICARE Select enrollee.

If the provider on your authorization is:

• A TRICARE network provider, you can keep seeing your provider until the authorization ends or Sept. 30, 2025, whichever comes first.
• No longer a TRICARE network provider, you can keep seeing your provider but you'll pay a non-network 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.. To avoid higher costs, ask for a new authorization to a TRICARE network provider. 

What about TRICARE Autism Care Demonstration participants?

All services under the Autism Care Demonstration must follow the rules of the demonstration. When an authorization expires, a new one must be in place before getting care again. Learn more on the TRICARE Autism Care Demonstration page.