Is your provider in-network? (West Region)

Did you know if you see a provider who isn’t in-network, you may have to pay point-of-service fees?

When using a network provider:

• You’ll pay less out-of-pocket.
• You’ll only have to pay your cost-shareA percentage of the total cost of a covered health care service that you pay. to the provider.
• Your provider will collect the rest of the amount directly from TRICARE.

When should you see a network provider?

• If you’re enrolled in TRICARE Prime or TRICARE Young Adult-Prime, your primary care manager is a network provider. Additionally, your PCM will refer you to network providers for specialty careSpecialized medical/surgical diagnosis, treatment, or services a primary care provider isn’t qualified to provide..
• If you’re enrolled in TRICARE Prime Remote, you’ll see a network provider if there are any in your remote location.
• If you’re enrolled in TRICARE Select, TRICARE Reserve Select, or TRICARE Retired Reserve, network providers will charge you less for care. However, you’re free to see network or non-network providers for your care. 

When might you see a non-network provider?

• You may see non-network providers when using TRICARE Select, TRICARE Reserve Select, TRICARE Retired Reserve, or TRICARE Young Adult-Select.
• If you’re enrolled in TRICARE Prime Remote, you’ll see non-network providers if there are no network providers 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.
  • Your regional contractor approves it because no other providers are available.

Check the West Region Provider Directory to ensure your provider is in network. To learn how to search for providers or military hospitals and clinics; interpret provider profiles; and find additional resources, watch the How To Navigate the Provider Directory video.