TRICARE Reference Room: TRICARE Provider Types
With TRICARE Standard, you have the flexibility to seek care from any TRICARE-authorized provider. To help you understand the types of providers you may choose, here are some descriptions.
Network Providers
Each of the three TRICARE regions—North, South and West—offers a civilian provider network. The TRICARE provider network includes civilian doctors, hospitals and other health care providers who meet special credentialing standards.
If you choose to obtain care from a network provider, you’ll be using the TRICARE Extra option and will pay lower cost-shares. In addition, network providers are required to file claims on your behalf.
Non-network Providers
A non-network provider is one who has not established a TRICARE network contractual relationship with the regional contractor in your TRICARE region, but who is authorized to provide care to TRICARE beneficiaries. Non-network providers may determine whether they are “participating” with TRICARE or “nonparticipating” on a claim-by-claim basis:
Additionally, nonparticipating providers may charge you up to 15 percent above the TRICARE-allowable charge, in addition to your normal costshare. This amount cannot be reimbursed when you file your claims, nor does it count towards your TRICARE deductible or catastrophic cap.
As you can see, you’ll save money and time by visiting a non-network provider who participates with TRICARE.
Non-authorized Providers
Non-authorized providers are not certified by TRICARE to render services to TRICARE beneficiaries. Note: If you receive care from a non-authorized provider, you will be responsible for the entire bill for the health care services you receive.
Online Provider Directory
To check a provider’s TRICARE-authorized or network status, refer to the TRICARE provider directory. You can also consult Humana Military's provider locator for assistance in locating a provider.
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