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Participating Providers Save You Money
Providers who “participate” (or accept assignment) in TRICARE agree to accept the TRICARE allowable charge as their full fee for your care. Therefore, after you have met your annual deductible, your CHCBP benefit will be based only on the allowable charge—no matter what the provider actually bills you. So with providers who participate in TRICARE and accept the allowable charge as full payment, you pay only your cost-share on the allowable charge for CHCBP covered care and for charges for any care you received not covered by CHCBP.
Remember ...
Providers who do not participate will bill you for their normal charges. The law says that their normal charges may be up to 15 percent more than the TRICARE allowable charge. That means you pay your cost-share and you pay any difference between the allowable charge and the actual bill, up to the legal billing limit—15 percent above the TRICARE allowable charge.
What Providers Participate in TRICARE?
Before getting care, call and ask if the provider participates (or will participate) in TRICARE. Be sure they understand that by “participating in TRICARE Standard,” they are agreeing to accept the TRICARE allowable charge as their full fee for your care. If the provider isn’t familiar with TRICARE or has any questions, they may call Humana Military at 1-800-444-5445.
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